ArticleNeurourology and urodynamics2024
Predicting success using response after lead implantation with sacral neuromodulation for urgency incontinence.
Article in Neurourology and urodynamics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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Who cites it
2 citing papers in PubMed.
- Electrical Pudendal Nerve Stimulation as an Initial Neuromodulation Strategy for Neurogenic Urinary Retention.European urology open science · 2026Article
- Sacral Neuromodulation for Refractory Overactive Bladder: Closing the Gaps in Anatomy, Mechanisms, and Parameter Selection.Advances in therapy · 2026Review
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
importanceMany women report inadequate symptom control after sacral neuromodulation (SNM), despite 50% reduction in urgency incontinence episodes (UUIE) after test stimulation.
objectiveTo determine the ideal percent UUIE reduction after test stimulation that predicts 24-month success. STUDY
designUsing data from a multicenter SNM trial, we constructed receiver operating characteristic curves to identify an ideal threshold of percent UUIE reduction after test stimulation. We defined 24-month success as Patient Global Impression of Improvement of "very much better" to "better." We compared predictive accuracy of two models predicting success: (1) percent UUIE reduction alone and (2) with baseline characteristics.
resultsOf 149 women (median [IQR] baseline daily UUIE 4.7 [3.7, 6.0]), the ideal threshold for 24-month success was 72% (95% confidence interval 64,76%) UUIE reduction with accuracy 0.54 (0.42, 0.66), sensitivity 0.71 (0.56, 0.86) and specificity 0.27 (0.05, 0.55). The accuracy of the 50% reduction threshold was 0.60 (0.49, 0.71), sensitivity 0.95 (0.88, 1.0) and specificity 0.04 (0.0, 0.12). Percent reduction in UUIE was not better than chance in predicting 24-month success (concordance index [c-index] 0.47 [0.46, 0.62]); adding age, body mass index, diabetes mellitus and visual or hearing impairment the c-index was 0.68 (0.61, 0.78).
conclusionsAmong women who received an internal pulse generator (IPG) due to ≥50% UUIE reduction after test stimulation, we found no ideal threshold that better predicted 24-month success. Percent reduction in UUIE after test stimulation poorly predicts 24-month success with or without clinical factors. Given this, re-evaluating how we determine who should receive an IPG is needed.
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