Author's Accepted Manuscript Impact of Age and Comorbidities on Utilization of Sacral Neuromodulation Anna ER. Faris , Bradley C. Gill , Javier Pizarro-Berdichevsky , Elodi Dielubanza , Marisa M. Clifton , Henry Okafor , Howard B. Goldman , Courtenay K. Moore , Raymond R. Rackley , Sandip P. Vasavada
PII: DOI: Reference:
S0022-5347(17)30227-6 10.1016/j.juro.2017.02.020 JURO 14367
To appear in: The Journal of Urology Accepted Date: 3 February 2017 Please cite this article as: Faris AE, Gill BC, Pizarro-Berdichevsky J, Dielubanza E, Clifton MM, Okafor H, Goldman HB, Moore CK, Rackley RR, Vasavada SP, Impact of Age and Comorbidities on Utilization of Sacral Neuromodulation, The Journal of Urology® (2017), doi: 10.1016/j.juro.2017.02.020. DISCLAIMER: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our subscribers we are providing this early version of the article. The paper will be copy edited and typeset, and proof will be reviewed before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to The Journal pertain.
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ACCEPTED MANUSCRIPT
Impact of Age and Comorbidities on Utilization of Sacral Neuromodulation
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Anna ER Faris1; Bradley C Gill1-3; Javier Pizarro-Berdichevsky2,4,5; Elodi Dielubanza2; Marisa M Clifton2; Henry Okafor2; Howard B Goldman1,2; Courtenay K Moore1,2; Raymond R Rackley1,2; Sandip P Vasavada1,2 1
Lerner College of Medicine, Education Institute, Cleveland Clinic, Cleveland, Ohio;
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Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio
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Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic
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Urogynecology unit, Dr. Sotero del Rio Hospital, Santiago, Chile
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Division de Obstetricia y Ginecologia, Pontificia Universidad Catolica de Chile
Corresponding Author: Sandip P Vasavada, MD
Center for Female Pelvic Medicine and Reconstructive Surgery
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Department of Urology, Glickman Urological and Kidney Institute, Cleveland Clinic Mail Stop Q10-1 | 9500 Euclid Ave Cleveland, OH 44195
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Tel: (216) 445-0296 | Fax: (216) 445-2267 | E-Mail:
[email protected]
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Running Head: Utilization of Sacral Neuromodulation with Age
ACCEPTED MANUSCRIPT
ABSTRACT Purpose: To investigate the influence of patient age on sacral nerve stimulation(SNS) trial outcomes, device implantation, and treatment durability.
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Materials and Methods: A database of all SNS procedures between 2012-2014 at a high-volume institution was analyzed for associations of age with SNS indication, trial stimulation success, device revision, and device explantation.
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Results: Within a 356 patient cohort, non-obstructive urinary retention and urgency- frequency patients were younger than those with urgency urinary incontinence. Trial stimulation success did not differ with age for Stage 1 (p=0.51) or percutaneous nerve evaluation (p=0.84) trials. Logistic regression identified greater odds of trial success in females (OR=2.97, 95%CI=[1.326.04] p=0.009) compared to males, and for urgency urinary incontinence compared to urgencyfrequency(OR=3.02, 95%CI=[1.39-6.50] p=0.006). Of the patients analyzed, there were 119 surgical revisions, including battery replacements, and 53 explants. Age was associated with a decreased risk of revision, with 3% lower odds per year older (OR=0.97, 95%CI[0.95-0.98] p
