학술논문

One‐year outcomes of the ARTISAN‐SNM study with the Axonics System for the treatment of urinary urgency incontinence
Document Type
article
Source
Neurourology and Urodynamics. 39(5)
Subject
Clinical Trials and Supportive Activities
Bioengineering
Clinical Research
Aging
Urologic Diseases
Renal and urogenital
Adult
Aged
Aged
80 and over
Electric Stimulation Therapy
Electrodes
Implanted
Fecal Incontinence
Female
Follow-Up Studies
Humans
Lumbosacral Plexus
Male
Middle Aged
Patient Satisfaction
Prostheses and Implants
Quality of Life
Surveys and Questionnaires
Treatment Outcome
Urinary Incontinence
Urge
Urinary Retention
Urologic Surgical Procedures
Young Adult
clinical trial
implantable neurostimulator
overactive bladder
sacral neuromodulation
urinary urgency incontinence
Clinical Sciences
Neurosciences
Urology & Nephrology
Language
Abstract
AimsSacral neuromodulation (SNM) is a guideline-recommended treatment for voiding dysfunction including urgency, urge incontinence, and nonobstructive retention as well as fecal incontinence. The Axonics® System is a miniaturized, rechargeable SNM system designed to provide therapy for at least 15 years, which is expected to significantly reduce revision surgeries as it will not require replacement as frequently as the non-rechargeable SNM system. The ARTISAN-SNM study is a pivotal study designed to treat patients with urinary urgency incontinence (UUI). Clinical results at 1-year are presented.MethodsA total of 129 eligible UUI patients were treated. All participants were implanted with a quadripolar tined lead and neurostimulator in a single procedure. Efficacy data were collected using a 3-day bladder diary, a validated quality of life questionnaire (ICIQ-OABqol), and a participant satisfaction questionnaire. Therapy responders were defined as participants with ≥50% reduction in UUI episodes compared to baseline. Data were analyzed on all 129 participants.ResultsAt 1 year, 89% of the participants were therapy responders. The average UUI episodes per day reduced from 5.6 ± 0.3 at baseline to 1.4 ± 0.2. Participants experienced an overall clinically meaningful improvement of 34 points on the ICIQ-OABqol questionnaire. All study participants (100%) were able to recharge their device at 1 year, and 96% of participants reported that the frequency and duration of recharging was acceptable. There were no serious device-related adverse events.ConclusionsThe Axonics System is safe and effective at 1 year, with 89% of participants experiencing clinically and statistically significant improvements in UUI symptoms.