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Repeatability of tools to assist in the follow up and troubleshooting of sacral neuromodulation patients using the sensory response
Purpose: Sacral neuromodulation (SNM) is an established minimally invasive
therapy for functional disorders of the pelvic organs in which electrodes are
stimulated in proximity of the sacral spinal nerves. Reprogramming of the electrodes
is regularly required and is based on the sensory response. This study assesses the
repeatability of a pelvic chart and grading system to enable a more objective
assessment of the sensory response upon electrode stimulation.
Material and Methods: In 26 SNM patients, with OAB or NOUR, assessment of
the sensory response was done using the sensory threshold (ST) and a pelvic chart
with 1 cm2 coordinates, each coordinate corresponding with a dermatome and
location of sensation (LoS). A grading system was developed based upon the ST
and LoS. Repeatability of ST was assessed using a two-way mixed effects,
absolute agreement, single rater/measurement intraclass correlation coefficient
...
Show morePurpose: Sacral neuromodulation (SNM) is an established minimally invasive
therapy for functional disorders of the pelvic organs in which electrodes are
stimulated in proximity of the sacral spinal nerves. Reprogramming of the electrodes
is regularly required and is based on the sensory response. This study assesses the
repeatability of a pelvic chart and grading system to enable a more objective
assessment of the sensory response upon electrode stimulation.
Material and Methods: In 26 SNM patients, with OAB or NOUR, assessment of
the sensory response was done using the sensory threshold (ST) and a pelvic chart
with 1 cm2 coordinates, each coordinate corresponding with a dermatome and
location of sensation (LoS). A grading system was developed based upon the ST
and LoS. Repeatability of ST was assessed using a two-way mixed effects,
absolute agreement, single rater/measurement intraclass correlation coefficient
(ICC), and displayed using a correlation and Bland Altman plot. Repeatability of
dermatomes, LoS, and grading system was assessed using kappa correlation
coefficient.
Results: On average, 1.55 ± 0.85 coordinates were used to point out the area where
the stimulation was perceived. The mean amount of coordinates between the area
pointed at during the first and second measurement was 0.47 ± 0.74. ST showed
excellent repeatability (ICC 0.93, 95%CI 0.90-0.94, P < 0.001). Dermatomes, LoS
and grading system showed a substantial to almost perfect agreement (κ = 0.740-
0.833, P < 0.001).
Conclusions: The pelvic chart and grading system, using the sensory response upon
electrode stimulation, are repeatable tools and can be used to assist in follow up and
troubleshooting of SNM patients.
Show less- All authors
- Vaganee, D.; Borne, S. van de; Fransen, E.; Voorham, J.; Voorham-van der Zalm, P.; Wachter, S. de
- Date
- 2019-01-15
- Journal
- Neurourology and Urodynamics