Sacral neuromodulation for symptomatic chronic urinary retention in females: do age and comorbidities make a difference?

• Published in: International Urogynecology Journal Vol. 32; no. 10; pp. 2703 - 2715
• Main Authors: High, Rachel A., Winkelman, William, Panza, Joseph, Sanderson, Derrick J., Yuen, Hyde, Halder, Gabriela E., Shaver, Courtney, Bird, Erin T., Rogers, Rebecca G., Danford, Jill M.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.10.2021; Springer Nature B.V
• Subjects: Age; Catheters; Electric stimulation therapy; Gynecology; Medicine; Medicine & Public Health; Original Article; Urinary retention; Urology; Aging; Urinary retention; Elderly; Sacral neuromodulation
• ISSN: 0937-3462; 1433-3023
• DOI: 10.1007/s00192-020-04485-0

Objectives To evaluate if age and medical comorbidities are associated with progression to implantation of sacral neuromodulation devices in women with symptomatic chronic urinary retention. Methods This multisite retrospective cohort included women with symptomatic chronic urinary retention who had a trial phase of sacral neuromodulation. The primary outcome was progression to implantation. Post-implantation outcomes were assessed as stable response versus decreased efficacy. A sub-analysis of catheter-reliant (intermittent-self catheterization or indwelling) patients was performed. Age was analyzed by 10-year units (decades of age). Multivariate logistic regression determined odds ratios for outcomes of implantation and for post-implantation stable response. Results Implantation occurred in 86% (243/284) women across six academic institutions. Most patients (160/243, 66%) were catheter reliant at the time of trial phase. Increased decade of age was associated with reduced implantation in all women [OR 0.54 (95% CI 0.42, 0.70)] and in the subgroup of catheter-reliant women [OR 0.52 (95% CI 0.37, 0.73)]. Post-implantation stable response occurred in 68% (193/243) of women at median follow-up of 2 years (range 0.3–15 years). Medical comorbidities present at the time of trials did not impact progression to implantation or post-implantation success. Conclusions Increasing decade of age is associated with reduced implantation in women with symptomatic chronic urinary retention. There is no age cutoff at which outcomes change. Post-implantation stable response was not associated with age or medical comorbidities.