LBA01-04 INTRAOPERATIVE PREDICTORS OF SACRAL NEUROMODULATION IMPLANTATION & TREATMENT RESPONSE - RESULTS FROM THE ROSETTA TRIAL Article Swipe

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Bradley C. Gill , Cindy L. Amundsen , Sonia Thomas , Lindsey Barden , Ariana L. Smith , Yuko M. Komesu , J. Eric Jelovsek ·

YOU? · · 2020 · Open Access · · DOI: https://doi.org/10.1097/ju.0000000000000946.04

You have accessJournal of UrologyLate-Breaking Abstracts (LBA1)1 Apr 2020LBA01-04 INTRAOPERATIVE PREDICTORS OF SACRAL NEUROMODULATION IMPLANTATION & TREATMENT RESPONSE - RESULTS FROM THE ROSETTA TRIAL Bradley Gill*, Cindy L Amundsen, Sonia Thomas, Lindsey Barden, Ariana Smith, Yuko Komesu, and J Eric Jelovsek Bradley Gill*Bradley Gill* More articles by this author , Cindy L AmundsenCindy L Amundsen More articles by this author , Sonia ThomasSonia Thomas More articles by this author , Lindsey BardenLindsey Barden More articles by this author , Ariana SmithAriana Smith More articles by this author , Yuko KomesuYuko Komesu More articles by this author , and J Eric JelovsekJ Eric Jelovsek More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000946.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Introduction: Few data exist on intra-operative stimulation responses in Sacral Neurmodulation (SNM) for Overactive Bladder (OAB). This study tested hypotheses that lower intra-op amplitudes with stronger motor and/or sensory responses were associated with successful test stimulation, as well as fewer urgency urinary incontinence episodes (UUIE) after implant. Methods: As part of the prospective, randomized, multi-center ROSETTA trial, intra-op details of SNM stage 1 were collected: responsive electrodes, amplitudes, and strength of motor and sensory response (Likert scale). Surgeons were instructed to achieve intra-op motor or sensory response at amplitudes < 5V on = 2 electrodes. Participants with stage 1 success (= 50% reduction in UUIE on 3-day diary) received a stage 2 implant. Demographics, baseline OAB symptoms, and therapy response were recorded in the primary trial. An intra-op amplitude-response score for each electrode was calculated, ranging from 0 (no response at high amplitude) to 90 (maximum response at 1 V). Statistical methods included Fisher’s exact test, as well as logistic and linear regression. Results: Of 161 women with intra-op data, 141 (88%) had a positive motor or sensory response at < 5V on = 2 electrodes; 139 (86%) had stage 1 success, while 22 (14%) did not. Demographics, baseline symptoms, and surgery duration did not differ by stage 1 result. Stage 1 success did not differ by number of electrodes with intra-op motor and/or sensory response, average amplitude at responsive electrodes, or minimum amplitude producing responses. Relative to other electrodes, a best amplitude-response score for pelvic bellows at electrode 3 was associated with stage 1 failure (11/22 (50%) vs 36/138 (26%); p=0.0409). This was the strongest predictor of Stage 1 response in stepwise and LASSO logistic modeling. Similarly, in a linear model of Stage 1 percent improvement in daily UUIE, a best amplitude-response score for pelvic bellows at electrode 3 was associated with lower percent improvement (mean ± standard deviation = 66% ± 31, N=47 vs 79% ± 25, N=113, p=0.008). After stage 2, mean daily UUIE reduction at 24 months was less for patients with an intra-op sensation response at electrode 3 (mean ± SD = -2.5 ± 2.2, N=115) than without (-5.0 ± 3.2, N=22, p=0.005). No intra-op variables predicted change in UUIE at 6 months. Conclusions: Intraoperative data during stage 1 sacral neuromodulation show a limited ability to predict trial stimulation outcome, but were constrained by small sample size. Future research into optimal stimulus parameters is needed. Source of Funding: NICHD PFDN © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e1020-e1021 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Bradley Gill* More articles by this author Cindy L Amundsen More articles by this author Sonia Thomas More articles by this author Lindsey Barden More articles by this author Ariana Smith More articles by this author Yuko Komesu More articles by this author J Eric Jelovsek More articles by this author Expand All Advertisement PDF downloadLoading ...

Related Topics

Medicine

Implant (Medicine)

Randomized Controlled Trial

Urinary Incontinence

Transcutaneous Electrical Nerve Stimulation

Internal Medicine

Histopathology

Alternative Medicine

Concepts

Medicine Overactive bladder Neuromodulation Implant Sacral nerve stimulation Randomized controlled trial Urinary incontinence Stimulation Surgery Internal medicine Pathology Alternative medicine

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Type: article
Language: en
Landing Page: https://doi.org/10.1097/ju.0000000000000946.04
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Title: LBA01-04 INTRAOPERATIVE PREDICTORS OF SACRAL NEUROMODULATION IMPLANTATION & TREATMENT RESPONSE - RESULTS FROM THE ROSETTA TRIAL

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Authors: Bradley C. Gill, Cindy L. Amundsen, Sonia Thomas, Lindsey Barden, Ariana L. Smith, Yuko M. Komesu, J. Eric Jelovsek

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Concepts: Medicine, Overactive bladder, Neuromodulation, Implant, Sacral nerve stimulation, Randomized controlled trial, Urinary incontinence, Stimulation, Surgery, Internal medicine, Pathology, Alternative medicine

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abstract_inverted_index.1	182, 218, 268, 310, 328, 331, 374, 389, 404, 493
abstract_inverted_index.2	213, 231, 304
abstract_inverted_index.3	369, 419, 462
abstract_inverted_index.6	486
abstract_inverted_index.<	209, 300
abstract_inverted_index.=	212, 303, 430, 466
abstract_inverted_index.J	38, 98, 598
abstract_inverted_index.L	27, 51, 53, 563
abstract_inverted_index.a	229, 293, 360, 399, 410, 497
abstract_inverted_index.(=	220
abstract_inverted_index.2,	443
abstract_inverted_index.22	313
abstract_inverted_index.24	449
abstract_inverted_index.5V	210, 301
abstract_inverted_index.90	264
abstract_inverted_index.An	246
abstract_inverted_index.As	168
abstract_inverted_index.No	478
abstract_inverted_index.OF	11
abstract_inverted_index.Of	284
abstract_inverted_index.SD	465
abstract_inverted_index.an	456
abstract_inverted_index.as	156, 158, 276, 278
abstract_inverted_index.at	207, 260, 267, 299, 348, 367, 417, 448, 460, 485
abstract_inverted_index.by	46, 57, 66, 75, 84, 93, 105, 326, 336, 508, 527, 546, 559, 567, 574, 581, 588, 595, 603
abstract_inverted_index.in	128, 223, 242, 391, 398, 407, 483
abstract_inverted_index.is	518
abstract_inverted_index.of	3, 170, 179, 190, 338, 387, 402, 521
abstract_inverted_index.on	124, 211, 225, 302
abstract_inverted_index.or	204, 296, 351
abstract_inverted_index.to	113, 200, 263, 357, 500
abstract_inverted_index.vs	378, 435
abstract_inverted_index.©	525
abstract_inverted_index.±	427, 432, 437, 464, 468, 474
abstract_inverted_index.(no	258
abstract_inverted_index....	611
abstract_inverted_index.139	306
abstract_inverted_index.141	290
abstract_inverted_index.161	285
abstract_inverted_index.25,	438
abstract_inverted_index.31,	433
abstract_inverted_index.50%	221
abstract_inverted_index.66%	431
abstract_inverted_index.79%	436
abstract_inverted_index.All	109, 607
abstract_inverted_index.Apr	7
abstract_inverted_index.Few	121
abstract_inverted_index.OAB	235
abstract_inverted_index.PDF	609
abstract_inverted_index.SNM	180
abstract_inverted_index.THE	21
abstract_inverted_index.V).	269
abstract_inverted_index.You	0
abstract_inverted_index.and	37, 97, 188, 192, 237, 280, 320, 393, 532, 551
abstract_inverted_index.but	505
abstract_inverted_index.did	315, 323, 333
abstract_inverted_index.for	132, 250, 364, 414, 453
abstract_inverted_index.had	292, 308
abstract_inverted_index.not	324, 334
abstract_inverted_index.the	171, 243, 384
abstract_inverted_index.was	253, 370, 383, 420, 451
abstract_inverted_index.-2.5	467
abstract_inverted_index.2.2,	469
abstract_inverted_index.2020	526, 545
abstract_inverted_index.3.2,	475
abstract_inverted_index.Eric	39, 99, 101, 599
abstract_inverted_index.FROM	20
abstract_inverted_index.More	44, 55, 64, 73, 82, 91, 103, 557, 565, 572, 579, 586, 593, 601
abstract_inverted_index.N=47	434
abstract_inverted_index.PFDN	524
abstract_inverted_index.This	136, 382
abstract_inverted_index.UUIE	224, 446, 484
abstract_inverted_index.View	108
abstract_inverted_index.Yuko	35, 88, 591
abstract_inverted_index.best	361, 411
abstract_inverted_index.data	122, 490
abstract_inverted_index.each	251
abstract_inverted_index.from	256
abstract_inverted_index.have	1
abstract_inverted_index.high	261
abstract_inverted_index.into	514
abstract_inverted_index.less	452
abstract_inverted_index.mean	444
abstract_inverted_index.not.	316
abstract_inverted_index.part	169
abstract_inverted_index.show	496
abstract_inverted_index.test	154
abstract_inverted_index.than	471
abstract_inverted_index.that	140
abstract_inverted_index.this	47, 58, 67, 76, 85, 94, 106, 560, 568, 575, 582, 589, 596, 604
abstract_inverted_index.well	157, 277
abstract_inverted_index.were	150, 183, 198, 240, 506
abstract_inverted_index.with	144, 152, 216, 287, 340, 372, 422, 455
abstract_inverted_index.(-5.0	473
abstract_inverted_index.(14%)	314
abstract_inverted_index.(50%)	377
abstract_inverted_index.(86%)	307
abstract_inverted_index.(88%)	291
abstract_inverted_index.(SNM)	131
abstract_inverted_index.(mean	426, 463
abstract_inverted_index.3-day	226
abstract_inverted_index.After	441
abstract_inverted_index.Cindy	26, 50, 562
abstract_inverted_index.Gill*	43, 556
abstract_inverted_index.LASSO	394
abstract_inverted_index.N=22,	476
abstract_inverted_index.NICHD	523
abstract_inverted_index.Smith	81, 585
abstract_inverted_index.Sonia	29, 61, 570
abstract_inverted_index.Stage	330, 388, 403
abstract_inverted_index.TRIAL	23
abstract_inverted_index.UUIE,	409
abstract_inverted_index.after	165
abstract_inverted_index.daily	408, 445
abstract_inverted_index.data,	289
abstract_inverted_index.exact	274
abstract_inverted_index.exist	123
abstract_inverted_index.fewer	159
abstract_inverted_index.lower	141, 423
abstract_inverted_index.model	401
abstract_inverted_index.motor	146, 191, 203, 295, 342
abstract_inverted_index.other	358
abstract_inverted_index.score	249, 363, 413
abstract_inverted_index.size.	511
abstract_inverted_index.small	509
abstract_inverted_index.stage	181, 217, 230, 309, 327, 373, 442, 492
abstract_inverted_index.study	137
abstract_inverted_index.test,	275
abstract_inverted_index.trial	502
abstract_inverted_index.while	312
abstract_inverted_index.women	286
abstract_inverted_index.(11/22	376
abstract_inverted_index.(26%);	380
abstract_inverted_index.(OAB).	135
abstract_inverted_index.(UUIE)	164
abstract_inverted_index.36/138	379
abstract_inverted_index.4April	538
abstract_inverted_index.Ariana	33, 79, 584
abstract_inverted_index.Author	110
abstract_inverted_index.Barden	72, 578
abstract_inverted_index.Expand	606
abstract_inverted_index.Future	512
abstract_inverted_index.Gill*,	25
abstract_inverted_index.Komesu	90, 592
abstract_inverted_index.N=113,	439
abstract_inverted_index.N=115)	470
abstract_inverted_index.SACRAL	12
abstract_inverted_index.Sacral	129
abstract_inverted_index.Smith,	34
abstract_inverted_index.Source	520
abstract_inverted_index.Thomas	63, 571
abstract_inverted_index.Volume	535
abstract_inverted_index.and/or	147, 343
abstract_inverted_index.author	48, 59, 68, 77, 86, 95, 107, 561, 569, 576, 583, 590, 597, 605
abstract_inverted_index.change	482
abstract_inverted_index.diary)	227
abstract_inverted_index.differ	325, 335
abstract_inverted_index.during	491
abstract_inverted_index.linear	281, 400
abstract_inverted_index.months	450
abstract_inverted_index.number	337
abstract_inverted_index.pelvic	365, 415
abstract_inverted_index.sacral	494
abstract_inverted_index.sample	510
abstract_inverted_index.tested	138
abstract_inverted_index.trial,	176
abstract_inverted_index.trial.	245
abstract_inverted_index.(LBA1)1	6
abstract_inverted_index.(Likert	195
abstract_inverted_index.Barden,	32
abstract_inverted_index.Bladder	134
abstract_inverted_index.Bradley	24, 41, 555
abstract_inverted_index.Komesu,	36
abstract_inverted_index.Lindsey	31, 70, 577
abstract_inverted_index.RESULTS	19
abstract_inverted_index.ROSETTA	22, 175
abstract_inverted_index.Thomas,	30
abstract_inverted_index.ability	499
abstract_inverted_index.achieve	201
abstract_inverted_index.average	346
abstract_inverted_index.bellows	366, 416
abstract_inverted_index.details	178
abstract_inverted_index.failure	375
abstract_inverted_index.limited	498
abstract_inverted_index.methods	271
abstract_inverted_index.minimum	352
abstract_inverted_index.months.	487
abstract_inverted_index.needed.	519
abstract_inverted_index.optimal	515
abstract_inverted_index.percent	405, 424
abstract_inverted_index.predict	501
abstract_inverted_index.primary	244
abstract_inverted_index.ranging	255
abstract_inverted_index.result.	329
abstract_inverted_index.scale).	196
abstract_inverted_index.sensory	148, 193, 205, 297, 344
abstract_inverted_index.success	219, 332
abstract_inverted_index.surgery	321
abstract_inverted_index.therapy	238
abstract_inverted_index.urgency	160
abstract_inverted_index.urinary	161
abstract_inverted_index.without	472
abstract_inverted_index.(maximum	265
abstract_inverted_index.203Issue	536
abstract_inverted_index.Abstract	119
abstract_inverted_index.American	528, 547
abstract_inverted_index.Amundsen	54, 564
abstract_inverted_index.Funding:	522
abstract_inverted_index.Jelovsek	40, 102, 600
abstract_inverted_index.Methods:	167
abstract_inverted_index.RESPONSE	17
abstract_inverted_index.Relative	356
abstract_inverted_index.Results:	283
abstract_inverted_index.Surgeons	197
abstract_inverted_index.ToolsAdd	112
abstract_inverted_index.articles	45, 56, 65, 74, 83, 92, 104, 558, 566, 573, 580, 587, 594, 602
abstract_inverted_index.baseline	234, 318
abstract_inverted_index.duration	322
abstract_inverted_index.episodes	163
abstract_inverted_index.implant.	166, 232
abstract_inverted_index.included	272
abstract_inverted_index.intra-op	142, 177, 202, 247, 288, 341, 457, 479
abstract_inverted_index.logistic	279, 395
abstract_inverted_index.outcome,	504
abstract_inverted_index.patients	454
abstract_inverted_index.positive	294
abstract_inverted_index.received	228
abstract_inverted_index.recorded	241
abstract_inverted_index.research	513
abstract_inverted_index.response	194, 206, 239, 259, 266, 298, 390, 459
abstract_inverted_index.standard	428
abstract_inverted_index.stepwise	392
abstract_inverted_index.stimulus	516
abstract_inverted_index.strength	189
abstract_inverted_index.stronger	145
abstract_inverted_index.success,	311
abstract_inverted_index.2020Page:	539
abstract_inverted_index.Abstracts	5
abstract_inverted_index.Amundsen,	28
abstract_inverted_index.Copyright	542
abstract_inverted_index.Education	531, 550
abstract_inverted_index.JelovsekJ	100
abstract_inverted_index.Research,	533, 552
abstract_inverted_index.TREATMENT	16
abstract_inverted_index.amplitude	347, 353
abstract_inverted_index.deviation	429
abstract_inverted_index.electrode	252, 368, 418, 461
abstract_inverted_index.modeling.	396
abstract_inverted_index.p=0.005).	477
abstract_inverted_index.p=0.008).	440
abstract_inverted_index.predicted	481
abstract_inverted_index.predictor	386
abstract_inverted_index.producing	354
abstract_inverted_index.reduction	222, 447
abstract_inverted_index.response,	345
abstract_inverted_index.responses	127, 149
abstract_inverted_index.sensation	458
abstract_inverted_index.strongest	385
abstract_inverted_index.symptoms,	236, 319
abstract_inverted_index.variables	480
abstract_inverted_index.Fisher’s	273
abstract_inverted_index.KomesuYuko	89
abstract_inverted_index.Overactive	133
abstract_inverted_index.PREDICTORS	10
abstract_inverted_index.Similarly,	397
abstract_inverted_index.Supplement	537
abstract_inverted_index.Urological	529, 548
abstract_inverted_index.amplitude)	262
abstract_inverted_index.amplitudes	143, 208
abstract_inverted_index.associated	151, 371, 421
abstract_inverted_index.collected:	184
abstract_inverted_index.electrodes	339
abstract_inverted_index.hypotheses	139
abstract_inverted_index.instructed	199
abstract_inverted_index.p=0.0409).	381
abstract_inverted_index.parameters	517
abstract_inverted_index.responses.	355
abstract_inverted_index.responsive	185, 349
abstract_inverted_index.successful	153
abstract_inverted_index.Association	530, 549
abstract_inverted_index.Information	554
abstract_inverted_index.SmithAriana	80
abstract_inverted_index.Statistical	270
abstract_inverted_index.ThomasSonia	62
abstract_inverted_index.amplitudes,	187
abstract_inverted_index.calculated,	254
abstract_inverted_index.constrained	507
abstract_inverted_index.e1020-e1021	540
abstract_inverted_index.electrodes,	186, 350, 359
abstract_inverted_index.electrodes.	214
abstract_inverted_index.electrodes;	305
abstract_inverted_index.improvement	406, 425
abstract_inverted_index.randomized,	173
abstract_inverted_index.regression.	282
abstract_inverted_index.stimulation	126, 503
abstract_inverted_index.2020LBA01-04	8
abstract_inverted_index.Conclusions:	488
abstract_inverted_index.Gill*Bradley	42
abstract_inverted_index.IMPLANTATION	14
abstract_inverted_index.Participants	215
abstract_inverted_index.incontinence	162
abstract_inverted_index.multi-center	174
abstract_inverted_index.prospective,	172
abstract_inverted_index.stimulation,	155
abstract_inverted_index.Advertisement	541, 608
abstract_inverted_index.AmundsenCindy	52
abstract_inverted_index.BardenLindsey	71
abstract_inverted_index.Demographics,	233, 317
abstract_inverted_index.Introduction:	120
abstract_inverted_index.Permissions©	544
abstract_inverted_index.accessJournal	2
abstract_inverted_index.CitationsTrack	115
abstract_inverted_index.INTRAOPERATIVE	9
abstract_inverted_index.InTwitterEmail	118
abstract_inverted_index.Intraoperative	489
abstract_inverted_index.Neurmodulation	130
abstract_inverted_index.NEUROMODULATION	13
abstract_inverted_index.downloadLoading	610
abstract_inverted_index.intra-operative	125
abstract_inverted_index.neuromodulation	495
abstract_inverted_index.Inc.MetricsAuthor	553
abstract_inverted_index.favoritesDownload	114
abstract_inverted_index.amplitude-response	248, 362, 412
abstract_inverted_index.ShareFacebookLinked	117
abstract_inverted_index.UrologyLate-Breaking	4
abstract_inverted_index.CitationsPermissionsReprints	116
abstract_inverted_index.Inc.FiguresReferencesRelatedDetails	534
abstract_inverted_index.Informationhttps://doi.org/10.1097/JU.0000000000000946.04AboutPDF	111
cited_by_percentile_year
countries_distinct_count	1
institutions_distinct_count	7
citation_normalized_percentile.value	0.08652723
citation_normalized_percentile.is_in_top_1_percent	False
citation_normalized_percentile.is_in_top_10_percent	False