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Randomized prospective crossover study of interstim lead wire placement with curved versus straight stylet
Neurourology and urodynamics, 2014-06, Vol.33 (5), p.488-492
Jacobs, Stephanie A.
Lane, Felicia L.
Osann, Kathryn E.
Noblett, Karen L.
2014
Volltextzugriff (PDF)
Details
Autor(en) / Beteiligte
Jacobs, Stephanie A.
Lane, Felicia L.
Osann, Kathryn E.
Noblett, Karen L.
Titel
Randomized prospective crossover study of interstim lead wire placement with curved versus straight stylet
Ist Teil von
Neurourology and urodynamics, 2014-06, Vol.33 (5), p.488-492
Ort / Verlag
United States: Blackwell Publishing Ltd
Erscheinungsjahr
2014
Quelle
Wiley Online Library - AutoHoldings Journals
Beschreibungen/Notizen
Aims To assess whether InterStim lead wire placement with the curved stylet achieves motor response at lower amplitudes compared to straight stylet use. Methods This was a prospective, randomized, crossover study of patients scheduled for InterStim lead wire placement. All patients underwent lead wire testing with both the curved and straight stylets. Patients were randomized to determine stylet order, and then crossed‐over to the alternate. Intra‐operatively, the amplitude achieving motor response at each electrode was recorded. The stylet with lowest overall amplitudes was used for final placement. Primary outcome measure was amplitude requirement in the two deepest (0 and 1) electrodes. Secondary outcomes included amplitudes at the number 2 and 3 electrodes, combined amplitudes, stylet order, and adverse outcomes. Results Forty‐two patients were enrolled, 40 of whom were included in the final analysis. Mean age was 69 years (SD = 12.8) and mean BMI 27 (SD = 5.6). Indications for placement included: urge urinary incontinence (N = 26), urge/frequency (N = 25), non‐obstructive urinary retention (N = 5), and fecal incontinence (N = 10). There were no significant differences between randomized groups. Regardless of order, the curved stylet achieved a motor response at lower amplitudes in the deepest electrodes (P < 0.001). Combined amplitudes of all electrodes were also significantly lower with the curved stylet (P < 0.001). Subsequently, 88% underwent final “optimal” placement with curved stylet (N = 35). Conclusions The curved stylet for InterStim lead wire placement consistently achieved motor response at lower amplitudes. A brief intra‐operative exchange of stylets represents a minor procedural alteration that could maximize Implantable Pulse Generator battery life and facilitate programming. Neurourol. Urodynam. 33:488–492, 2014. © 2013 Wiley Periodicals, Inc.
Sprache
Englisch
Identifikatoren
ISSN: 0733-2467
eISSN: 1520-6777
DOI: 10.1002/nau.22437
Titel-ID: cdi_proquest_miscellaneous_1539466154
Format
–
Schlagworte
Aged
,
Aged, 80 and over
,
Cross-Over Studies
,
Electric Stimulation Therapy - instrumentation
,
Electric Stimulation Therapy - methods
,
Electrodes, Implanted
,
fecal incontinence
,
Fecal Incontinence - therapy
,
Female
,
Humans
,
Lumbosacral Plexus
,
Middle Aged
,
overactive bladder
,
Prosthesis Implantation - instrumentation
,
sacral nerve neuromodulation
,
Urinary Incontinence - therapy
,
urinary retention
,
Urinary Retention - therapy
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