Associate Clinical Professor, Department of Urology Yale University School of Medicine New Haven CT, Connecticut, United States
A subgroup of women has failed multiple medications and finds Botox unappealing. SNS can be a successful option for those patients, however it can be a leap of faith to convince them to put a ‘bladder pacemaker in their sacrum. Case studies of patients with refractory OAB and Urge incontinence will generate discussion on guidelines and implementation of SNS. We will discuss the newer choices on the market for SNS. Which patient would be best served by a small rechargeable battery? Is there a different patient who may need more programming options, and a non- rechargeable battery that will still last 5 years? Which patient may need extra assurance about the MRI compatibility?
We will discuss criteria for implantation for diabetics, patients with nonneurogenic-neurogenic bladders, and those with Interstitial Cystitis. Specialized handouts will be provided for the clinician to bring back to their practice to facilitate the development of a personalized evaluation and management plan for their patients. Cases will also highlight and identify a potential subgroup of patients with whom a referral to neurology or neurosurgery may be appropriate before 3rd line treatment is initiated.
Learning Objectives:
Review the guidelines for 3rd line treatment options while improving patient selection, as well as, how to communicate sometimes complicated information to patient in a simplified way.
Develop an algorithm and your own guidelines as to whom you may offer an Axonic’s rechargeable device versus the Medtronic’s non-rechargeable option.
Identify a potential subgroup of patients who may require further evaluation with urodynamics or referral to neurology or neurosurgery before implant consideration.
