Detailed analysis of adverse events and surgical interventions in a large prospective trial of sacral neuromodulation therapy for overactive bladder patients

Neurourol Urodyn. 2017 Apr;36(4):1136-1139. doi: 10.1002/nau.23076. Epub 2016 Aug 4.

Abstract

Introduction: The InSite trial is a prospective, multicenter study of sacral neuromodulation (SNM) therapy with the InterStim® System in subjects with overactive bladder (OAB). One of the primary aims of the study is to report on long-term safety of the tined lead. This analysis provides detailed descriptions of device-related adverse events (AEs) and surgical interventions to 12 months.

Methods: Analysis included those subjects who completed test stimulation with a tined lead, received a full implant, and reported device-related AEs out to 12 months. A Clinical Events Committee (CEC) adjudicated AEs to 12 months.

Results: Device-related AEs occurred in 30% (82/272) of subjects, with only one considered serious. Fifty-six percent of the device-related AEs occurred between implant and 3 months. The most frequent device-related AEs were undesirable change in stimulation (12%, 32/272); implant site pain (7%, 20/272); and implant site infection (3%, 9/272). Of the 26 events of implant site pain, 13 required surgical intervention, with only two resulting in explant. Ten subjects experienced 13 events of a surgical site infection (including an additional cellulitis), five of which resolved with antibiotics and eight required explantation. The overall surgical intervention rate was 13% with the most common reasons being pain at the surgical site (4%), lack/loss of efficacy (4%), and infection (3%).

Conclusions: Although a 30% AE rate was reported, most AEs were minor and were resolved without surgical intervention. Surgical intervention was required in 13% of subjects, with the majority being revision or replacement. Neurourol. Urodynam. 36:1136-1139, 2017. © 2016 Wiley Periodicals, Inc.

Keywords: adverse event; overactive bladder; sacral neuromodulation; surgical intervention.

Publication types

  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Electric Stimulation Therapy* / adverse effects
  • Female
  • Humans
  • Lumbosacral Plexus
  • Male
  • Postoperative Complications / therapy
  • Prospective Studies
  • Prosthesis Failure
  • Reoperation
  • Sacrum
  • Urinary Bladder, Overactive / therapy*