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Prior Back Surgery Not A Problem for IC/BPS Patients Who Need Neuromodulation

Bartley JM, Killinger KA, Boura JA, Gupta P, Gaines N, Gilleran JP, Peters KM. The impact of prior back surgery on neuromodulation outcomes: A review of over 500 patients. Neurourol Urodyn. 2016 Sep 27. doi: 10.1002/nau.23140. [Epub ahead of print]

Patients who have had back surgery in the past sometimes present with lower urinary tract problems. There is some concern that the prior back surgery could be problematic in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) who are selected to undergo neuromodulation, a treatment which involves the application of electrical current directly to nerves. Accordingly, this group of investigators carefully reviewed and evaluated 560 patients, of whom 109 (19%) had had back surgery; those patients tended to be older and were more likely to have urge urinary incontinence. However, implantation of a neuromodulation device was no less successful in this group of patients, and they had similar levels of interstitial cystitis symptoms and quality of life as compared with patients who had no prior back surgery. The back surgery patients were more likely to report incontinence before the treatment, but after the treatment, this parameter improved. The one difference investigators did find was that back surgery patients did not have a significant improvement in volume per void; however, most patients reported moderate/marked improvement in bladder symptoms overall. Based on that, investigators said their study showed that neuromodulation is a reasonable treatment option for IC/BPS patients whether or not a patient has undergone back surgery in the past.

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