The Effect of Pulse Rate Changes on the Clinical Outcome of Sacral Neuromodulation

No AccessJournal of UrologyAdult Urology1 May 2011The Effect of Pulse Rate Changes on the Clinical Outcome of Sacral Neuromodulation Tom A.T. Marcelissen, Randall K. Leong, Fred H.M. Nieman, Rob A. de Bie, Philip E.V. van Kerrebroeck, and Stefan G.G. de Wachter Tom A.T. MarcelissenTom A.T. Marcelissen Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands , Randall K. LeongRandall K. Leong Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands , Fred H.M. NiemanFred H.M. Nieman Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands , Rob A. de BieRob A. de Bie Department of Epidemiology, Maastricht University, Maastricht, The Netherlands , Philip E.V. van KerrebroeckPhilip E.V. van Kerrebroeck Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands , and Stefan G.G. de WachterStefan G.G. de Wachter Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands View All Author Informationhttps://doi.org/10.1016/j.juro.2010.12.089AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We evaluated the effect of pulse rate changes on the clinical response to and stimulation related pain symptoms of sacral neuromodulation treatment. Materials and Methods: In this pilot study we evaluated the effect of 4 pulse rates, including 5.2, 10, 21 and 40 Hz, in patients with a suboptimal response to sacral neuromodulation. The effect of each frequency was evaluated during a 6-day test period. To avoid the carryover effect stimulation was discontinued for 24 hours between consecutive test periods. On the last 3 days of each test period a voiding diary and questionnaire were completed. Changes in the clinical response and pain symptoms were compared between the 4 pulse rates using multivariate analysis. Results: Of the 50 patients included in the study 40 (80%) were female. Mean ± SD age was 55.5 ± 12.3 years. Of the patients 41 (82%) had overactive bladder symptoms and 9 (18%) were in chronic nonobstructive urinary retention. No significant difference was found in clinical outcome on the voiding diary and questionnaire between the pulse rates and none of the 4 rates was significantly related to sacral neuromodulation associated pain. However, individuals appeared to benefit from changing the pulse rate in terms of treatment efficacy and stimulation related pain. Conclusions: On the group level none of the 4 pulse rates appeared to have a significantly different effect on clinical outcome or sacral neuromodulation related pain. However, an individualized approach to optimize treatment efficacy by changing the pulse rate appears to be useful. References 1 : Sacral neuromodulation as an effective treatment for refractory pelvic floor dysfunction. Urology2002; 60: 52. Google Scholar 2 : Sacral neuromodulation in functional urinary retention: an effective way to restore voiding. BJU Int2002; 90: 662. 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Google Scholar 22 : Considerations for safety with chronically implanted nerve electrodes. Epilepsia1990; 31: S27. Google Scholar © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185 Issue 5 May 2011 Page: 1781-1785 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.Keywordsurinary bladder, overactiveurinary incontinenceelectric stimulationpulsepainMetrics Author Information Tom A.T. Marcelissen Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands Equal study contribution. More articles by this author Randall K. Leong Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands Equal study contribution. More articles by this author Fred H.M. Nieman Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands More articles by this author Rob A. de Bie Department of Epidemiology, Maastricht University, Maastricht, The Netherlands More articles by this author Philip E.V. van Kerrebroeck Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands Financial interest and/or other relationship with Medtronic, Astellas and Ferring. More articles by this author Stefan G.G. de Wachter Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands More articles by this author Expand All Advertisement PDF downloadLoading ...