Objectives: Numerous studies have documented a relationship between provider variables, including surgeon volume and specialty, and outcomes for surgical procedures. In this study we analyzed claims data from a Medicare database to analyze outcomes of sacral neuromodulation (SNM) with respect to both provider and patient factors.
Materials And Methods: A 5% random sample of Medicare beneficiaries from 1997 to 2007 was the data source. Data retrieved included demographic information, ICD-9 diagnosis codes, and CPT procedure codes. Multivariate analysis was performed to identify predictors of progression to implantable pulse generator (IPG) implantation.
Results: After stage I testing, urologists were more likely than gynecologists to proceed to IPG placement (Center for Medicare and Medicaid Services: 49% vs. 43%, p < 0.0001). After percutaneous testing, gynecologists were more likely than urologists to proceed to battery placement (63% vs.44%, p = 0.005). Among the patient variables analyzed, women were more likely than men to progress to battery placement. Patients treated by high-volume providers had higher rates of IPG placement after formal stage I trials (71% vs. 33%, p < 0.0001).
Conclusions: The rate of IPG implantation after SNM was greater among high-volume providers. Women had better outcomes than men. Further research may better define the relationship between outcomes of sacral neuromodulation and specific etiology of voiding dysfunction.
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http://dx.doi.org/10.1111/ner.12109 | DOI Listing |
Curr Pain Headache Rep
January 2025
Department of Anesthesia, Division of Pain Medicine, University of Virginia, Charlottesville, VA, USA.
Purpose Of Review: This paper aims to review pudendal neuralgia pathophysiology, risk factors, diagnosis, and treatment options.
Recent Findings: Conservative and pharmacologic options are first line treatments for the treatment of pudendal neuralgia. Interventional treatment such as, pudendal nerve blocks can be tried if first line treatments feel to provide adequate analgesia.
Int J Mol Sci
January 2025
Azriele Faculty of Medicine in the Galilee, Bar-Ilan University, Safed 1311502, Israel.
Provoked vulvodynia (PV) is the leading cause of vulvar pain and dyspareunia. The etiology of PV is multifactorial and remains poorly understood. PV is associated with a history of repeated vulvar inflammation and is often accompanied by sensory neuromodulation as a result of activation of the metabotropic glutamate receptor 5 (mGluR5) in the sensory nerve terminals.
View Article and Find Full Text PDFUrogynecology (Phila)
February 2025
From the Departments of Gynecology and Obstetrics.
Importance: Patients deciding between advanced therapies for overactive bladder syndrome may be interested to know the likelihood of treatment crossover after sacral neuromodulation, intradetrusor OnabotulinumtoxinA, or percutaneous tibial nerve stimulation. Treatment crossover was defined as a switch from one advanced therapy to another.
Objectives: The aim of this study was to estimate the rate of treatment crossover after each advanced therapy for nonneurogenic overactive bladder syndrome.
Urogynecology (Phila)
February 2025
From the University of Connecticut Health Center, Farmington, CT.
World J Gastroenterol
January 2025
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA 30912, United States.
Fecal incontinence is a common condition that can significantly impact patients' quality of life. Obstetric anal sphincter injury and anorectal surgeries are common etiologies. Endoanal ultrasound and anorectal manometry are important diagnostic tools for evaluating patients.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!