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Bart L.h. Bemelmans - One of the best experts on this subject based on the ideXlab platform.
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posterior tibial nerve stimulation in the treatment of Urge Incontinence
Neurourology and Urodynamics, 2003Co-Authors: Vera Vandoninck, Michael R. Van Balken, Enrico Finazzi Agrò, Filomena Petta, Carlo Caltagirone, John Heesakkers, Lambertus A. Kiemeney, Frans M.j. Debruyne, Bart L.h. BemelmansAbstract:AIMS: The objective of this study was to evaluate the effect of posterior tibial nerve stimulation (PTNS) for treatment of Urge Incontinence. METHODS: In a prospective multicentre study, 35 patients with complaints of Urge Incontinence underwent 12 weekly sessions of PTNS at one of five sites in the Netherlands and one site in Italy. Frequency/volume charts and I-QoL and SF-36 questionnaires were completed at 0 and 12 weeks. Success was analysed by using subjective and objective criteria. Overall subjective success was defined as the willingness to continue treatment, whereas objective success was defined as a significant decrease (to<50%) in total number of leakage episodes. RESULTS: Twenty-two patients (63%) reported a subjective success. Twenty-four patients (70%) showed a 50% or greater reduction in total number of leakage episodes. Sixteen (46%) of these-patients were completely cured (i.e., no leakage episodes) after 12 sessions. Quality of life parameters improved significantly. CONCLUSIONS: We conclude that posterior tibial nerve stimulation is an effective, minimally invasive option for treatment of patients with complaints of Urge Incontinence, as improvement was seen in subjective as well as objective parameters.
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Posterior tibial nerve stimulation in the treatment of Urge Incontinence.
Neurourology and Urodynamics, 2002Co-Authors: Vera Vandoninck, Michael R. Van Balken, Enrico Finazzi Agrò, Filomena Petta, Carlo Caltagirone, John Heesakkers, Lambertus A. Kiemeney, Frans M.j. Debruyne, Bart L.h. BemelmansAbstract:AIMS: The objective of this study was to evaluate the effect of posterior tibial nerve stimulation (PTNS) for treatment of Urge Incontinence. METHODS: In a prospective multicentre study, 35 patients with complaints of Urge Incontinence underwent 12 weekly sessions of PTNS at one of five sites in the Netherlands and one site in Italy. Frequency/volume charts and I-QoL and SF-36 questionnaires were completed at 0 and 12 weeks. Success was analysed by using subjective and objective criteria. Overall subjective success was defined as the willingness to continue treatment, whereas objective success was defined as a significant decrease (to
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Low-dose oxybutynin for the treatment of Urge Incontinence: good efficacy and few side effects.
European Urology, 2000Co-Authors: Bart L.h. Bemelmans, Lambertus A. Kiemeney, Frans M.j. DebruyneAbstract:Abstract Objective: Oxybutynin is an efficacious pharmacotherapeutic agent for the treatment of Urge Incontinence. However, many patients discontinue therapy because of
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Sacral root neuromodulation in the treatment of refractory urinary Urge Incontinence: a prospective randomized clinical trial.
European Urology, 2000Co-Authors: E.h.j. Weil, Bart L.h. Bemelmans, R. A. Janknegt, J. L. Ruiz-cerda, P. H. A. Eerdmans, Philip Van KerrebroeckAbstract:Objectives: To compare the effectiveness of sacral root neuromodulation with that of conservative management in ameliorating symptoms of refractory urinary Urge Incontinence and enh
Karl J Kreder - One of the best experts on this subject based on the ideXlab platform.
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efficacy of sacral neuromodulation for symptomatic treatment of refractory urinary Urge Incontinence
Urology, 2006Co-Authors: Jerilyn M Latini, Mohammad Alipour, Karl J KrederAbstract:Objectives To determine the efficacy and complications of sacral neuromodulation as therapy for refractory urinary Urge Incontinence. Methods Forty-one patients (mean age 54.3 ± 15.8 years) with Urge Incontinence refractory to conservative therapy (ie, pharmacologic, behavioral, biofeedback therapy) were retrospectively evaluated. The patients included those who received permanent one-staged or two-staged InterStim implants. Surgical implantation of the InterStim was performed in patients who experienced a greater than 50% reduction in Urge Incontinence symptoms, as documented by voiding diaries during a 3 to 7-day test stimulation period. Results Ninety percent of patients had 50% or greater improvement in presenting symptoms and quality-of-life parameters after InterStim implantation, with a median follow-up of 12 months (interquartile range 12 to 26.5) for single-stage and 4.5 months (interquartile range 1.5 to 12) for staged implants (P = 0.0003 Wilcoxon rank-sum test). Patients with Urge Incontinence had a significant reduction in mean leaking episodes (from 8.8 to 2.3 per day, P = 0.0001), with a significant decrease in the mean number of pads used (from 4.7 to 0.82 per day, P <0.0001). No patient experienced operative complications, and postoperative complications were encountered in 29% of patients. Conclusions Our results have demonstrated that sacral neuromodulation is a safe and effective approach for the treatment of urinary Urge Incontinence that is refractory to other more conservative forms of treatment.
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Efficacy of sacral neuromodulation for symptomatic treatment of refractory urinary Urge Incontinence.
Urology, 2006Co-Authors: Jerilyn M Latini, Mohammad Alipour, Karl J KrederAbstract:Objectives To determine the efficacy and complications of sacral neuromodulation as therapy for refractory urinary Urge Incontinence. Methods Forty-one patients (mean age 54.3 ± 15.8 years) with Urge Incontinence refractory to conservative therapy (ie, pharmacologic, behavioral, biofeedback therapy) were retrospectively evaluated. The patients included those who received permanent one-staged or two-staged InterStim implants. Surgical implantation of the InterStim was performed in patients who experienced a greater than 50% reduction in Urge Incontinence symptoms, as documented by voiding diaries during a 3 to 7-day test stimulation period. Results Ninety percent of patients had 50% or greater improvement in presenting symptoms and quality-of-life parameters after InterStim implantation, with a median follow-up of 12 months (interquartile range 12 to 26.5) for single-stage and 4.5 months (interquartile range 1.5 to 12) for staged implants (P = 0.0003 Wilcoxon rank-sum test). Patients with Urge Incontinence had a significant reduction in mean leaking episodes (from 8.8 to 2.3 per day, P = 0.0001), with a significant decrease in the mean number of pads used (from 4.7 to 0.82 per day, P
Cindy L. Amundsen - One of the best experts on this subject based on the ideXlab platform.
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sacral neuromodulation for the treatment of refractory urinary Urge Incontinence after stress Incontinence sUrgery
American Journal of Obstetrics and Gynecology, 2005Co-Authors: Neil D Sherman, George D. Webster, Margaret G. Jamison, Cindy L. AmundsenAbstract:Objective This study was undertaken to evaluate the response to sacral neuromodulation in women with refractory, nonobstructive urinary Urge Incontinence after stress Incontinence sUrgery. Study design We reviewed the medical records of women in whom sacral neuromodulation was performed for worsening or de novo urinary Urge Incontinence after a stress Incontinence procedure. All patients had undergone preliminary test stimulation. Demographics, surgical and urogynecologic history, including bladder diary and pad weight test, and urodynamic parameters were evaluated. Results Of 34 women, 22 (65%) responded to the test stimulation and underwent permanent lead implant. There was no difference between responders and nonresponders with respect to type of stress Incontinence sUrgery. Incontinence or urodynamic parameters were not different between responders and nonresponders. Factors that were predictive of a positive response were women aged less than 55 years ( P = .01), the test stimulation performed within 4 years of the stress Incontinence procedure ( P = .01), and evidence of pelvic floor muscle activity ( P = .03). Conclusion Sacral neuromodulation is a viable option for the treatment of refractory urinary Urge Incontinence that occurs after stress urinary Incontinence sUrgery. Older women with no pelvic floor activity who are remote from their Incontinence sUrgery may have a suboptimal response.
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Sacral neuromodulation for intractable Urge Incontinence: Are there factors associated with cure?
Urology, 2005Co-Authors: Cindy L. Amundsen, Audrey A. Romero, Margaret G. Jamison, George D. WebsterAbstract:Abstract Objectives To determine the variables that affect the cure rate in patients with Urge Incontinence treated with sacral neuromodulation. Methods This prospective analysis of patients with refractory urinary Urge Incontinence who underwent placement of a neuromodulator lead and generator was undertaken between October 2000 and December 2003. Quantitative assessment of the severity of their urinary leakage was assessed by preoperative and postoperative 3-day bladder diaries documenting leakage episodes, number of pads used per day, and a 24-hour pad weight assessment. Cure was defined as no daily leakage episodes after permanent implantation. Subjective outcome was assessed using the Incontinence Impact Questionnaire. Two-sample independent t tests, two-way chi-square tests, and tests of two proportions were performed when appropriate, with P Results The mean postimplantation follow-up was 29 months, and the average age was 60 years (range 29 to 83). The cure rate was associated with age, with individuals younger than 55 years having a statistically significant greater cure rate (65% versus 37% for older individuals; P Conclusions Age older than 55 years and more than three chronic conditions were independent factors associated with a lower cure rate in patients implanted with a sacral neuromodulator for refractory Urge Incontinence. A neurologic condition may be associated with a decrease in the cure rate.
Roger R Dmochowski - One of the best experts on this subject based on the ideXlab platform.
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management of refractory urinary Urge Incontinence following urogynecological sUrgery with sacral neuromodulation
Neurourology and Urodynamics, 2007Co-Authors: Jonathan S Starkman, Christopher Wolter, Harriette M Scarpero, Douglas F Milam, Roger R DmochowskiAbstract:Aims We sought to explore our patient outcomes utilizing sacral neuromodulation in the management of refractory urinary Urge Incontinence following urogynecological surgical procedures. Methods A total of 25 women with urinary Urge Incontinence following urogynecological sUrgery were selected for SNS therapy and retrospectively analyzed. All patients completed a comprehensive urological evaluation. Clinical data was recorded to determine outcomes and identify parameters that would be predictive of response to neuromodulation. Outcomes were determined via subjective patient questionnaire and graded as follows: significant response (≥80% improvement), moderate response (≥50% and <80% improvement), and poor response (<50% response). Results Nineteen patients had a previous pubovaginal sling (10 with concomitant pelvic prolapse repair), 3 a previous retropubic suspension, and 3 a transperitoneal vesicovaginal fistula repair. Urethrolysis was performed in 4 patients to alleviate bladder outlet obstruction prior to sacral neuromodulation. Mean patient age was 59.8 years and length of follow-up was 7.2 months. Twenty-two women (88%) had the IPG placed during a Stage 2 procedure. Twenty patients maintained at least a 50% improvement in clinical symptoms at last follow-up and 6 patients were continent. Overall, the number of pads/day improved from 4.2 to 1.1 (P < 0.001). There were no significant differences in response to neuromodulation based upon age, duration of symptoms, type of sUrgery, or urodynamic parameters. Conclusion Sacral neuromodulation appears to be an effective therapy in patients with refractory Urge Incontinence following urogynecological sUrgery. Larger prospective studies with longer follow-up are needed to assess the durability of this therapeutic modality. Neurourol. Urodynam. © 2006 Wiley-Liss, Inc.
Jerilyn M Latini - One of the best experts on this subject based on the ideXlab platform.
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efficacy of sacral neuromodulation for symptomatic treatment of refractory urinary Urge Incontinence
Urology, 2006Co-Authors: Jerilyn M Latini, Mohammad Alipour, Karl J KrederAbstract:Objectives To determine the efficacy and complications of sacral neuromodulation as therapy for refractory urinary Urge Incontinence. Methods Forty-one patients (mean age 54.3 ± 15.8 years) with Urge Incontinence refractory to conservative therapy (ie, pharmacologic, behavioral, biofeedback therapy) were retrospectively evaluated. The patients included those who received permanent one-staged or two-staged InterStim implants. Surgical implantation of the InterStim was performed in patients who experienced a greater than 50% reduction in Urge Incontinence symptoms, as documented by voiding diaries during a 3 to 7-day test stimulation period. Results Ninety percent of patients had 50% or greater improvement in presenting symptoms and quality-of-life parameters after InterStim implantation, with a median follow-up of 12 months (interquartile range 12 to 26.5) for single-stage and 4.5 months (interquartile range 1.5 to 12) for staged implants (P = 0.0003 Wilcoxon rank-sum test). Patients with Urge Incontinence had a significant reduction in mean leaking episodes (from 8.8 to 2.3 per day, P = 0.0001), with a significant decrease in the mean number of pads used (from 4.7 to 0.82 per day, P <0.0001). No patient experienced operative complications, and postoperative complications were encountered in 29% of patients. Conclusions Our results have demonstrated that sacral neuromodulation is a safe and effective approach for the treatment of urinary Urge Incontinence that is refractory to other more conservative forms of treatment.
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Efficacy of sacral neuromodulation for symptomatic treatment of refractory urinary Urge Incontinence.
Urology, 2006Co-Authors: Jerilyn M Latini, Mohammad Alipour, Karl J KrederAbstract:Objectives To determine the efficacy and complications of sacral neuromodulation as therapy for refractory urinary Urge Incontinence. Methods Forty-one patients (mean age 54.3 ± 15.8 years) with Urge Incontinence refractory to conservative therapy (ie, pharmacologic, behavioral, biofeedback therapy) were retrospectively evaluated. The patients included those who received permanent one-staged or two-staged InterStim implants. Surgical implantation of the InterStim was performed in patients who experienced a greater than 50% reduction in Urge Incontinence symptoms, as documented by voiding diaries during a 3 to 7-day test stimulation period. Results Ninety percent of patients had 50% or greater improvement in presenting symptoms and quality-of-life parameters after InterStim implantation, with a median follow-up of 12 months (interquartile range 12 to 26.5) for single-stage and 4.5 months (interquartile range 1.5 to 12) for staged implants (P = 0.0003 Wilcoxon rank-sum test). Patients with Urge Incontinence had a significant reduction in mean leaking episodes (from 8.8 to 2.3 per day, P = 0.0001), with a significant decrease in the mean number of pads used (from 4.7 to 0.82 per day, P
