Sacral neuromodulation for refractory urge XXXX is less effective following spinal surgery.

@entity1 @entity322 @entity16 @entity409 @entity74
@entity1 with @entity74 and @entity409 have been reported to respond poorly to sacral neuromodulation. We report on our experience in treating voiding symptoms with sacral neuromodulation after spinal surgery. The medical charts of @entity1 evaluated for sacral neuromodulation from 2000-2008 were retrospectively reviewed. Indications, need for explantation, and clinical success (>50% symptom improvement) were recorded. The cohort of @entity1 who had undergone prior spinal surgery was compared to @entity1 with no history of spinal surgery or @entity16 . Thirty-two @entity1 with a history of spinal surgery and 136 with no history of @entity16 underwent sacral neuromodulation testing. Twenty @entity1 and @entity1 (62.5%) from the spinal surgery group ultimately underwent permanent implantation. Seventeen of the 32 @entity1 were diagnosed with urge @entity322 , of whom 52.9% reported a successful outcome at a mean of 2.3 years of follow-up, compared to an 80.3% success rate in @entity1 with no history of spinal surgery (p=0.018). Sixteen of 32 carried a diagnosis of urgency/frequency with 62.5% success at last follow-up, compared 73.9% (p=0.35) of those without a history of spinal surgery or @entity16 . Thirteen of 32 @entity1 diagnosed with urinary retention experienced a 61.5% long-term success rate, compared with 63.6% for those without spinal surgery and urinary retention. Six of 20 (30.0%) in the spinal surgery group were explanted at a mean time of 2.9 years, compared with 27 of 102 (26.5%) of the non-neurologic @entity1 . Clinical success can be achieved using sacral neuromodulation in @entity1 with @entity409 and a history of spinal surgery; however, those with urge @entity322 are less likely to report significant improvement.
