Volume 30, Issue 7 pp. 1249-1252
Original Clinical Article

PNE versus 1st stage tined lead procedure: A direct comparison to select the most sensitive test method to identify patients suitable for sacral neuromodulation therapy

Randall K. Leong

Randall K. Leong

Department of Urology, Maastricht University Hospital, Maastricht, The Netherlands

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Stefan G.G. De Wachter

Stefan G.G. De Wachter

Department of Urology, Maastricht University Hospital, Maastricht, The Netherlands

Urologist.

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F.H.M. Nieman

F.H.M. Nieman

Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center, Maastricht, The Netherlands

Statistician.

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Rob A. de Bie

Rob A. de Bie

Department of Epidemiology, Maastricht University, Maastricht, The Netherlands

Professor of Physiotherapy Research.

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Philip E.V. van Kerrebroeck MD, PhD

Corresponding Author

Philip E.V. van Kerrebroeck MD, PhD

Department of Urology, Maastricht University Hospital, Maastricht, The Netherlands

Professor of Urology.

Department Urology, Maastricht University Medical Center, Postbus 5800, 6202 WC Maastricht, The Netherlands.Search for more papers by this author
First published: 14 March 2011
Citations: 60

Conflicts of interest: none.

Dirk De Ridder led the review process.

Abstract

Aims

To compare the patient's response rate to the Percutaneous Nerve Evaluation test (PNE) and the 1st stage tined-lead placement test (FSTLP) for sacral neuromodulation therapy (SNM).

Methods

Single center study on patients with refractory idiopathic overactive bladder syndrome (OAB) or non-obstructive urinary retention, screened with both PNE and FSTLP. Patients were followed prospectively and their response rate based on bladder diary after PNE was compared to that after FSTLP. More than 50% improvement in at least two relevant urinary symptoms was considered a positive response. A Wilcoxon paired test was done to compare the rates of the two screening options and logistic regression to determine possible associations. A follow-up was conducted to determine the long-term failure rate.

Results

One hundred patients were included (82 female, 69 OAB). The mean age was 55 years (SD 13). The positive response rate on PNE was 47%. FSTLP showed a 69% positive response rate, which was negatively related to age. The 22% gain in positive response was statistically significant (P < 0.001) and positively associated with female gender and younger age. All 69 patients with a positive response to FSTLP received SNM treatment. Failure rate after an average of 2 years was 2.9%.

Conclusions

This study suggests that FSTLP may be a more sensitive screening method than PNE to identify patients eligible for SNM therapy, warranting randomized trials. Neurourol. Urodynam. 30:1249–1252, 2011. © 2011 Wiley-Liss, Inc.

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