San Francisco—Findings of a retrospective review of patients treated with sacral neuromodulation (SNM) for overactive bladder (OAB) speak to the modality’s efficacy as third-line therapy, but also point to a need to better understand why some patients continue concurrent medical therapy, said Katherine Amin, MD, at the AUA annual meeting in San Francisco.
In a study that included data from 78 patients followed for a median of approximately 16 months after the SNM procedure, the authors found that 64 patients (82.1%) stopped and never restarted their OAB medications. Comparisons with the group of individuals who continued to consistently fill an OAB medication prescription for 1 year or more showed the two cohorts differed significantly only in age, with the patients remaining on medical therapy being older than their counterparts utilizing SNM alone (74.5 vs. 64.9 years, p=.004).
Other comparisons showed the two groups were similar with respect to body mass index, sex, SNM revision rate, urodynamic parameters, patient-perceived percentage of improvement, and Patient Global Impression of Improvement (PGI-I) score.
“Considering that symptom improvement and patient satisfaction were equivalent in the groups that discontinued and remained on OAB medications, we believe that SNM can successfully treat OAB and avoid the adverse effects of OAB medications, which may include detrimental cognitive effects with long-term usage of agents with anticholinergic activity,” said Dr. Amin, fellow in female pelvic reconstructive medicine and surgery at Virginia Mason, Seattle.