AUA 2004 - Sacral Neuromodulation and IC

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Program#/Poster#: 361

Presentation Title:
SACRAL NEUROMODULATION FOR THE TREATMENT OF INTERSTITIAL CYSTITIS

Presentation Time: 5/9/2004 8:00:00 AM

Author Block: Craig Comiter. university of arizona, Tucson, AZ

Introduction and Objective: We evaluated the efficacy of sacral neuromodulation for the treatment of symptoms in patients with refractory interstitial cystitis.

Methods: Twenty-seven patients (mean age 47 years) with refractory interstitial cystitis were prospectively evaluated with a trial of sacral nerve stimulation. All patients had failed dietary modification, pharmacotherapy, and hydrodistention. Those individuals who demonstrated 50% improvement in frequency, nocturia, voided volume, and average pain qualified for permanent sacral nerve stimulator implantation. Treatment success was measured by voiding diary, report of average pain, and response to the Interstitial Cystitis Symptom Index and Interstitial Cystitis Problem Index.

Results: Nineteen patients qualified for permanent sacral nerve stimulator implantation. At an average of 26 months follow-up, mean daytime frequency and nocturia improved from 17.1 to 11.9 and 4.5 to 2.5, respectively (p<0.01). Mean voided volume increased from 111 ml. to 215 ml. (p<0.01). Report of average pain decreased from 5.8 to 2.6 points on a scale of 0-10 (p<0.01). Interstitial Cystitis Symptom and Problem Index scores decreased from 16.5 to 9.2 and 14.5 to 7.5, respectively, (p<0.01). 15 of 19 patients with a permanent stimulator (79%) demonstrated sustained improvement in all parameters at the last post-operative visit.

Conclusions: Results of this prospective clinical study demonstrate that sacral neuromodulation is a safe and effective treatment for the dysfunctional voiding and pelvic pain in patients with interstitial cystitis who are refractory to other forms of treatment.