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Dr. Dreyfuss shares insights from study of sacral neuromodulation in older patients

Opinion
Video

“Overall, I think this study will allow clinicians to better advise patients in the slightly complex landscape of OAB therapies,” says Leo Dreyfuss, MD.

In this video, Leo Dreyfuss, MD, discusses insights gleaned from the Neurourology and Urodynamics paper, “Sacral neuromodulation in nursing home residents: Predictors of success and complications in a national cohort of older adults.” Dreyfuss is a urology resident at NewYork-Presbyterian Hospital/Weill Cornell Medical, New York, New York.

Transcription:

Beyond the results presented in this study, are there any additional insights you gained from this study that you believe would be valuable for future research on SNM in older adults with OAB?

Overall, I think this study will allow clinicians to better advise patients in the slightly complex landscape of OAB therapies, particularly as the new OAB guidelines abandon the old stepwise approach in favor of a more patient-centered approach that allows for earlier use of these minimally invasive therapies in the treatment paradigm. Obviously, sacral neuromodulation is a costly procedure. And while cost effectiveness was beyond the scope of this study, I think future studies looking at the cost effectiveness of this procedure in older patients who may have limited life expectancies is important. It's also important that researchers look at patient-reported outcomes and social support as possible factors that may impact these types of studies going forward. That said, we did show that outcomes in this study were comparable to previous claims-based cohort studies looking at similar outcomes in younger populations. And while sacral neuromodulation may not be appropriate for all nursing home residents or all older adults, we think that it may be a good option for certain individuals, pending they have appropriate life expectancy and social support and other factors. And certainly, we would not want to systematically exclude these patients based solely on their chronological age, from this potentially life-improving treatment.

This transcription was edited for clarity.

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