Troubleshooting Interstim Sacral Neuromodulation Generators to Recover Function

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

Purpose of Review: Sacral neuromodulation (SNM) is being used to treat lower urinary tract symptoms (LUTS) with growing popularity among clinicians in multiple specialties. As this therapy becomes more common in the USA and Europe, urologists will encounter more patients implanted with SNM generators. Recent Findings: Over time, it has recently been understood that up to 53% will develop pain at the implant site as reported by Groen et al. (J Urol 186:954, 2011) and 3–38% will lose effective stimulation as reported by Al-zahrani et al. (J Urol 185:981, 2011) and White et al. (Urology 73:731, 2009). There is a paucity of troubleshooting methodology in the literature, apart from revision surgery, to salvage the SNM generator. In fact, it has been suggested that one contemporary series’ failure rate is lower than some historic series because of the ability to reprogram devices as reported by Siegel et al. (J Urol 199:229, 2018). Standard algorithms for such reprogramming efforts are lacking in the literature and may salvage some patients otherwise destined for surgical revision or addition of multimodal therapy to achieve acceptable symptom control. Summary: It is possible to troubleshoot and thereby salvage many SNM generators, saving patients from surgical revision in many cases and increasing the number of patients with persistent benefit from SNM. The algorithms presented in this manuscript represent a systematic strategy for reprogramming and troubleshooting SNM generators.

Original languageEnglish (US)
Article number86
JournalCurrent Urology Reports
Volume19
Issue number10
DOIs
StatePublished - Oct 1 2018

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Reoperation
Lower Urinary Tract Symptoms
Aptitude
Urology
Pain
Equipment and Supplies
Therapeutics

Keywords

  • Bladder
  • Electric stimulation
  • Equipment safety
  • Neuromodulation
  • Prosthesis and implants
  • Urinary frequency
  • Urinary incontinence
  • Urinary urgency

ASJC Scopus subject areas

  • Urology

Cite this

Troubleshooting Interstim Sacral Neuromodulation Generators to Recover Function. / Powell, Charles.

In: Current Urology Reports, Vol. 19, No. 10, 86, 01.10.2018.

Research output: Contribution to journalReview article

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abstract = "Purpose of Review: Sacral neuromodulation (SNM) is being used to treat lower urinary tract symptoms (LUTS) with growing popularity among clinicians in multiple specialties. As this therapy becomes more common in the USA and Europe, urologists will encounter more patients implanted with SNM generators. Recent Findings: Over time, it has recently been understood that up to 53{\%} will develop pain at the implant site as reported by Groen et al. (J Urol 186:954, 2011) and 3–38{\%} will lose effective stimulation as reported by Al-zahrani et al. (J Urol 185:981, 2011) and White et al. (Urology 73:731, 2009). There is a paucity of troubleshooting methodology in the literature, apart from revision surgery, to salvage the SNM generator. In fact, it has been suggested that one contemporary series’ failure rate is lower than some historic series because of the ability to reprogram devices as reported by Siegel et al. (J Urol 199:229, 2018). Standard algorithms for such reprogramming efforts are lacking in the literature and may salvage some patients otherwise destined for surgical revision or addition of multimodal therapy to achieve acceptable symptom control. Summary: It is possible to troubleshoot and thereby salvage many SNM generators, saving patients from surgical revision in many cases and increasing the number of patients with persistent benefit from SNM. The algorithms presented in this manuscript represent a systematic strategy for reprogramming and troubleshooting SNM generators.",
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