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Aims: This study was sought to evaluate the efficacy and durability of sacral neuromodulation in the treatment of bladder pain syndrome (BPS) patients., Methods: A retrospective chart review was performed of patients who had unilateral sacral nerve stimulator (InterStim®) for refractory BPS between June 2002 and December 2004. Patients were qualified for permanent implantation by showing ≥ 50% improvement in their bladder pain and voiding symptoms 1-week post-percutaneous nerve evaluation (PNE). Voiding diary was completed at pre-implantation, 1 year, and on the last visit. Urinary distress inventory short form was completed pre-implantation and on the last visit. Bladder pain was evaluated by visual analogue scale. Primary outcome was improvement in bladder pain. Differences among groups were compared by one-way ANOVA and t-test. Statistical significance was set at P ≤ 0.05., Results: Twenty-one female patients diagnosed with BPS had PNE; 11 patients (52%) showed ≥ 50% improvement in their bladder pain and voiding symptoms and they consider candidates for permanent implantation (Table I), while 10 patients (48%) failed to show 50% improvement in their voiding symptoms or bladder pain (Table II). In those 11 patients who underwent permanent implantation, the average patient's age was 44.3 ± 8.9 years; average time since diagnosis was 3 ± 0.8 years; the average follow- up was 71.5 ± 9.3 months (Table III). There was significant improvement in the bladder pain and voiding parameters at 1-year follow-up, which was maintained at 5-year follow-up. There was continuous improvement in urgency (1.2 ± 0.68) at 1-year follow-up, and (0.98 ± 0.72) at the last visit. Average voided volume was also continuously improved from 242 ± 62.7 ml at 1-year follow-up to 276 ± 64.7 ml on the last visit., Conclusion: Sacral neuromodulation as part of multimodal treatment provides an effective long-term treatment option for sub-group of refractory BPS., (Copyright © 2011 Wiley-Liss, Inc.)

Objectives:   This study sought to determine the association between stimulation parameters at the time of implantation and loss of efficacy on long-term follow-up., Material and Methods:   Between 2002 and 2007, 143 patients underwent selective sacral nerve root stimulation at our center as a treatment for voiding dysfunction. Nine patients were explanted because of loss of efficacy. The patients' charts were retrospectively reviewed and compared with those of a well-matched group of 12 positive responders. A t-test was used to determine the differences in voiding parameters and stimulation parameters between both groups (at p < 0.05)., Results:   The baseline amplitude levels in the loss of efficacy group were significantly higher than those of the control group (2.08 ± 0.35 V vs. 1.27 ± 0.25 V) (p= 0.008). The impedance levels were significantly higher in the loss of efficacy group than the control (1032.4 ± 181 Ω vs. 590 ± 44.6 Ω) (p= 0.025)., Conclusion:   High stimulation parameters at the time of implantation were associated with loss of efficacy at the long-term follow-up., (© 2011 International Neuromodulation Society.)