International Urogynecology Journal

, Volume 14, Issue 4, pp 223–228 | Cite as

Sacral neuromodulation for the treatment of refractory interstitial cystitis: outcomes based on technique

  • Kenneth M. Peters
  • Jeffrey M. Carey
  • David B. Konstandt
Original Article

Abstract

Patients with refractory interstitial cystitis (IC) underwent testing with sacral nerve modulation via either a traditional percutaneous approach or a staged procedure. Implanted patients were followed with scaled questionnaires and voiding diaries. Twenty-six patients who had a permanent InterStim placed had a reduction in 24-h voids of 51%. More than two-thirds of patients reported a moderate or marked improvement in urinary frequency, urgency, pelvic pain, pelvic pressure, incontinence and overall quality of life. The test to implant rate of a traditional percutaneous procedure was 52%, compared to a staged procedure of 94%. Assessing sensory response at the time of implant reduced the reoperation rate from 43% to 0%. Ninety-six per cent stated they would undergo an implant again and recommend the therapy to a friend. We concluded that sacral nerve modulation can treat refractory IC symptoms. The response to therapy and the reoperation rate are dependent on the technique used to test and implant the device.

Keywords

Electric stimulation Implant  Interstitial cystitis Sacrum Urination disorders 

Abbreviations

IC

Interstitial cystitis

TENS

Transcutaneous electrical nerve stimulation

Notes

Acknowledgements

We would like to thank Brian Doughty, our Medtronic Therapy Consultant, for his unrelenting energy, enthusiasm and expertise regarding InterStim therapy.

References

  1. 1.
    Baskin LS, Tanagho EA (1992) Pelvic pain without pelvic organs. J Urol 147:683–686Google Scholar
  2. 2.
    Fall M, Carlsson CA, Erlandson BE (1980) Electrical stimulation in interstitial cystitis. J Urol 123:192–195Google Scholar
  3. 3.
    Geirsson G, Wang Y-H, Lindstrom S, Fall M (1993) Traditional acupuncture and electrical stimulation of the posterior tibial nerve. Scand J Urol Nephrol 27:67–70Google Scholar
  4. 4.
    Fall M (1987) Transcutaneous electrical nerve stimulation in interstitial cystitis. Urology 29(Suppl):40–42Google Scholar
  5. 5.
    Everaert K, Devulder J, De Muynck M et al. (2001) The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes. Int Urogynecol J 12:9–14Google Scholar
  6. 6.
    Schmidt RA, Bruschini H, Tanagho EA (1979) Urinary bladder and sphincter responses to stimulation of dorsal and ventral sacral roots. Invest Urol 16:300–304Google Scholar
  7. 7.
    Schmidt RA, Tanagho EA (1979) Feasibility of controlled micturition through electrical stimulation. Urol Int 34:199–230Google Scholar
  8. 8.
    Chai TC, Zhang C, Warren JW, Keay S (2000) Percutaneous sacral third nerve root neurostimulation improves symptoms and normalizes urinary HB-EGF levels and antiproliferative activity in patients with interstitial cystitis. Urology 55:643–646Google Scholar
  9. 9.
    Maher CF, Carey MP, Dwyer PL, Schluter PL (2001) Percutaneous sacral nerve root neuromodulation for intractable interstitial cystitis. J Urol 165:884–886Google Scholar
  10. 10.
    Siegel S, Paszkiewicz E, Kirkpatrick C, Hinkel B, Oleson K (2001) Sacral nerve stimulation in patients with chronic intractable pelvic pain. J Urol 166:1742–1745Google Scholar
  11. 11.
    Thon WF, Baskin LS, Jonas U, Tanagho EA, Schmidt RA (1991) Neuromodulation of voiding dysfunction and pelvic pain. World J Urol 9:138–141Google Scholar
  12. 12.
    Siegel SW (1992) Management of voiding dysfunction with an implantable neuroprosthesis. Urol Clin North Am 19:163–170PubMedGoogle Scholar
  13. 13.
    Janknegt RA, Weil EHJ, Eerdmans PHA (1997) Improving neuromodulation for refractory voiding dysfunctions: two-stage implant. Urology 49:358–362CrossRefPubMedGoogle Scholar
  14. 14.
    Chai TC, Mamo GJ (2001) Modified techniques of S3 foramen localization and lead implantation in S3 neuromodulation. Urology 58:786–790Google Scholar

Copyright information

© International Urogynecological Association 2003

Authors and Affiliations

  • Kenneth M. Peters
    • 1
  • Jeffrey M. Carey
    • 1
  • David B. Konstandt
    • 1
  1. 1.Department of UrologyWilliam Beaumont HospitalRoyal OakUSA

Personalised recommendations