214 - Outcomes of Sacral Neuromodulation in Patients with Neurogenic Lower Urinary Tract Dysfunction – First Single Center Experience from Poland
Bibliographic record
Abstract
Hypothesis / aims of study To evaluate the outcomes of sacral neuromodulation (SNM) using the InterStim II system in patients with neurogenic lower urinary tract dysfunction (NLUTD), including both detrusor overactivity (DO) and detrusor underactivity (DU), in terms of subjective improvement, validated questionnaire scores (NBSS), post-void residual (PVR) volume, and frequency of clean intermittent catheterization (CIC). Study design, materials and methods This retrospective single center study included 50 patients treated with SNM between 2018 and 2024, with a minimum follow-up of one year. The implantation includes test phase and permanent implant. Among them, 26 (52%) had a diagnosis of neurogenic lower urinary tract dysfunction (NLUTD) secondary to conditions such as multiple sclerosis (n= 3), spinal cord injury (n=4), iatrogenic pelvic nerve lesions (n=3), or cauda equina syndrome (n=3), stroke (n=2), Spina Bifida (n=2), Parkinson’s disease (n=1). Subjective improvement, NBSS (Neurogenic Bladder Symptom Score) total score, post-void residual (PVR) volume, and the number of daily clean intermittent catheterizations (CICs) were assessed before and after SNM therapy. Therapeutic success was defined as a subjective improvement of at least 50% in urinary symptoms and quality of life and improvement in NBSS questionnaire. Results Therapeutic success was achieved in 18 of 26 NLUTD patients (69.2%). Mean subjective improvement among responders with DO was 66.2%, and in patients with DU it was 57.9% (p = 0.377). NBSS total scores significantly improved in both subgroups: DU group: from 32.6 to 20.7 (p = 0.016) DO group: from 51.5 to 35.25 (p < 0.001) In DU patients, the median PVR volume significantly decreased from 300 ml to 150 ml (p = 0.0057), and the median number of daily CICs dropped from 5 to 2.5 (p = 0.0206). Interpretation of results Sacral neuromodulation appears to be an effective treatment for NLUTD in both subtypes, significantly improving symptom burden and quality of life. While subjective improvement was slightly higher in patients with DO, the difference between groups was not statistically significant. In DU patients, SNM contributed to a significant reduction in PVR and CIC frequency. Concluding message This is the first large Polish study evaluating SNM in NLUTD. Our results confirm that SNM is a highly effective therapy for selected patients with neurogenic bladder dysfunction, consistent with outcomes from major international centers. Download: Download high-res image (85KB) Download: Download full-size image Figure 1 . Download: Download high-res image (51KB) Download: Download full-size image Figure 2 . Funding None Clinical Trial No Subjects Human Ethics Committee The Bioethics Committee of Nicolaus Copernicus University in Torun at the Ludwik Rydygier Collegium Medicum in Bydgoszcz Helsinki Yes Informed Consent Yes
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".