Cycling Versus Continuous Mode In Neuromodulator Programming: A Crossover, Randomized, Controlled Trial

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Abstract

Introduction

Neuromodulation is thought to stimulate S2-S4 afferent nerves originating in the pelvic organs to the spinal cord. To date, there is limited research on evaluating whether administering cycling mode or continuous mode impacts patient's symptom scores on their Overactive Bladder Questionnaire - Short Form (OABq-SF).

Purpose

The purpose of this research was to evaluate if there is a superior program mode for sacral neuromodulation (cycling versus continuous) in the treatment of refractory overactive bladder symptoms in women.

Methods

A randomized, controlled, blind, crossover trial comparing cycling mode to continuous mode using validated questionnaires and 3-day voiding diaries. Data were collected at baseline, 3 and 6 months.

Results

Using the OABq-SF as the primary outcome, Patient Global Impression of Improvement (PGI-I), and voiding diaries at 3 months, no differences were found between the groups Group A (cycling mode followed by continuous) and Group B (continuous mode followed by cycling) At 6 months, Group A reported statistically significant improvement in their OABq-SF symptom score (p > 0.02).

Conclusion

The order effect, cycling followed by continuous mode stimulation, resulted in greater OABq-SF symptom improvement.

Level of Evidence - II

(Polit & Beck, 2012)

Level of Evidence - II

This is a randomized, controlled, blind, crossover trial comparing cycling versus continuous programming of a sacral neuromodulator in women diagnosed with overactive bladder (OAB). At 6 months, treatment order significantly affected Overactive Bladder Questionnaire - Short Form (OABq-SF) symptom scores. The cycling followed by continuous stimulation group had superior OABq-SF scores (p > 0.02).

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