Abstract: PD39-04
Sources of Funding: None

Introduction

Detrusor hyperactivity with impaired contractility (DHIC) is a challenging condition to manage. Sacral neuromodulation (SNM) is a proven treatment modality for both the individual aspects of DHIC. To date, reporting the effect of SNM on a DHIC cohort of patients is lacking.

Methods

Consecutive patients undergoing SNM for DHIC were followed prospectively, from April 2013 to October 2016. Patient demographics, bladder diaries, subjective response rates, ICIQ-OAB and PGI-I scores were recorded. Success was defined as greater than 50% symptom improvement in urgency, urge incontinence, and a greater than 50% improvement in voided volume or reduction of post-void residual volumes.

Results

Twenty patients underwent stage 1 trial of SNM. Average age was 68.5 years, IQR (54.25 -76.25). 13 (65%) patients were female. 13/20 (65%) of patients had a response to the detrusor overactivity component. 10/20 (50%) of patients showed an improvement in the voiding component. 9/20 (45%) of patients showed responses to both components. 6/20 (30%) patients had no response whatsoever. Overall, 12/20 (60%) patients proceeded to insertion of an IPG. At follow up of 17 months, IQR (1.5 – 35), 11/12 (91.7%) of patients were still using the SNM device, median PGI score was 2, IQR (2 – 4). In addition, SNM resulted in statistically significant improvement in voided volume (p=0.016), PVR (p=0.0296), ICIQ-OAB score (p<0.0001) and ICIQ-OAB bother score (p=0.016).

Conclusions

SNM is a potential treatment option for DHIC with an acceptable success rate, treating both the detrusor hyperactivity, and impaired contractility components of this condition.

Funding

None