Neuromodulation Treatment for Refractory Interstitial Cystitis: Long-Term Follow-up
Michael P Feloney*1, Cedric K Olivera2, Ian A Oyama*1, Adam C Steinberg1, Kristene E Whitmore3
1UMDNJ/Robert Wood Johnson Medical School and Drexel University/Graduate Hospital, Philadelphia, PA;2Graduate Hospital, Philadelphia, PA;3Drexel University/Graduate Hospital, Philadelphia, PA
Introduction:
The purpose of this study was to evaluate the long term efficacy of sacral neuromodulation in the treatment of Interstitial Cystitis (IC).
Methods:
A retrospective chart review was performed on all patients with IC who had the InterStim® neuromodulation system permanently implanted before 2001 The 56 patients identified were mailed a questionnaire consisting of Global Response Assessment Scale, O’Leary-Sant questionnaire, and questions regarding frequency of voiding. A paired t-test and Wilcoxon signed-rank test was performed.
Results:
30 (54%) of the 56 patients (all female) were able to complete the questionnaire. Mean follow up time was 4.4 years (3.2-6.3 years). Mean age of patients who responded was 57.3 years (28-93) years. The mean average interval between voids pre implant was 1.22 hours and was 2.57 hours after long term treatment. This interval change was statistically significant p<.001 on the Wilcoxon rank test. Nocturia rates showed significant improvement (p=.001) on the paired t-test with the average nocturia rate of 3.43 pre-implant that changed to 1.21 post implant long-term. 24 (88%) of the 27 patients who completed the global response assessment scale found their symptoms overall were improved. Of those, 20 indicated marked to moderate improvement, 4 (14.8%) indicated slight improvement, 2 (7.4%) indicated no change, and one (3.7%) patient indicated that her symptoms worsened during the treatment.
Conclusions:
Sacral Nerve Stimulation proves to have long term sustained efficacy in the treatment of urinary symptoms in Interstitial Cystitis.
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