1160 CORRELATION BETWEEN PRE-IMPLANTATION DIAGNOSIS AND CAUSES OF SACRAL NEUROSTIMULATOR EXPLANTATION: 10 YEARS EXPERIENCE
Bibliographic record
Abstract
You have accessJournal of UrologyUrodynamics/Incontinence/Female Urology: Incontinence - Evaluation & Therapy1 Apr 20111160 CORRELATION BETWEEN PRE-IMPLANTATION DIAGNOSIS AND CAUSES OF SACRAL NEUROSTIMULATOR EXPLANTATION: 10 YEARS EXPERIENCE Yahya Ghazwani, Mohamed Elkelini, and Magdy Hassouna Yahya GhazwaniYahya Ghazwani Toronto, Canada , Mohamed ElkeliniMohamed Elkelini Toronto, Canada , and Magdy HassounaMagdy Hassouna Toronto, Canada View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.770AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sacral neuromodulation has gained its popularity as an effective therapy for various voiding dysfunctions refractory to conservative and medical therapy.InterStim® is approved by FDA for treating urgency-incontinence, urgency/frequency syndrome and non-obstructive urinary retention. Sacral neuromodulation has also showed favorable results in relieving urinary symptoms and pelvic pain associated with Bladder Pain Syndrome. Despite all modifications in the surgical technique and implanted leads, explantation is still encountered in 5–15% of implanted InterStim® therapy. Our aim was to determine the association between indications of the InterStim® therapy and causes for explantation after long term follow-up. METHODS A retrospective chart review of patients who underwent permanent sacral implantation from 2000–2009 was carried out. All patients who had their InterStim® explanted were included. Ages, gender, pre-implantation diagnosis, duration of symptoms, duration of stimulation, and reason for explantation were retrieved. The causes of explantation included loss of efficacy and pain (at the site of IPG, or ipsilateral lower limb), infection, trauma and as precautions for MRI. RESULTS 167 patients were permanently implanted, 142 (85%) females and 25 (15%) males. Indications of implantation were: Overactive Bladder (OAB) 82 (49%) patients, 46 (28%) patients with urinary retention (UR), and 39 (23%) patients with Bladder Pain Syndrome (BPS). In total, 37 (22%) patients were explanted. Table 1 shows the reasons for explantation Loss of efficacy (59%) followed by pain (27%) represented the predominant causes of explantation. Average duration of stimulation in explanted patients was 4.5 ± 2.6 yrs. Patients who were explanted due to loss of efficacy had longer duration of stimulation when compared to patients who were explanted due to pain, (5.32± 2.5) Vs (3.1±0.1) yrs, p =0.011. BPS as an indication for Sacral neuromodulation was significantly correlated with pain as a cause of explantation (r=0.41, p=0.012). CONCLUSIONS In our cohort, explantation rate of sacral neurostimulator was 20% caused predominantly by loss of efficacy. We however found that explantation due to pain was associated with BPS. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e465-e466 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Yahya Ghazwani Toronto, Canada More articles by this author Mohamed Elkelini Toronto, Canada More articles by this author Magdy Hassouna Toronto, Canada More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".