67th Annual Meeting Abstracts

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Interstim II Implantable Generator Improves Surgical Time And Postoperative Pain After Neuromodulation

Stanley Zaslau, *Douglas Maxey, *James Namsupak, *Dale Riggs, *Barbara Jackson, Stanley J Kandzari
West Virginia University, Morgantown, WV

Introduction: Sacral neuromodulation (Interstim) is an FDA-approved treatment modality for refractory urgency/frequency, refractory urgency incontinence, and non-obstructive urinary retention. A new, smaller implantable generator (IPG) was FDA approved in August 2006. The purpose of this study is to present the authors’ experience with this new IPG.
Materials & Methods: Patients who underwent successful Stage II sacral neuromodulation with Interstim II were followed prospectively. All patients underwent upper tract evaluation, cystoscopy, and urodynamic evaluation before the Interstim Stage I procedure. Patients were deemed eligible for Stage II implantation if they demonstrated a 50% improvement in urinary frequency, urgency, and urgency incontinence. Patients with nonobstructive urinary retention were eligible for Stage II implantation if they demonstrated a significant reduction in need for self-intermittent catheterization, or were not using this modality and voiding on their own.
Results: The mean patient age was 46 years (n=58 females). All patients had refractory urgency/frequency or urgency incontinence. The operative time for Stage II implant was 22 minutes compared to 32 minutes for the prior larger IPG (Interstim I). Two patients (3%) had infections of their IPG. Eight patients with previously significant IPG pocket pain from the larger IPG were implanted with Interstim II. Their mean pocket pain score (scale 1-10) improved from eight with Interstim I to 2.5 with Interstim II.
Conclusions: Sacral neuromodulation with Interstim II improves surgical time and pocket-related pain compared with the larger Interstim I IPG. In addition, there is a low infection rate and no revisions have been required to date.

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