Percutaneous nerve evaluation (PNE) is an evaluative test done in patients with bladder control problems to find out who is a good candidate for sacral neuromodulation (SNM) therapy, or sacral nerve stimulation.
This therapy, sometimes referred to as InterStim therapy, is an FDA-approved therapy for sacral nerve stimulation for refractory overactive bladder (OAB), frequency-urgency syndrome and nonobstructive urinary retention.
An individual’s eligibility for sacral neuromodulation (SNM) therapy is determined through a screening process, one of which is percutaneous nerve evaluation, and the other is a staged test.
Doctors look for candidates who show more than 50% reduction in urinary symptoms during either of these tests as it is a reliable indication that these individuals are good candidates for SNM therapy.
Sacral nerve stimulation is designed for individuals for whom other more conservative treatments have failed or are not tolerated.
Bladder control issues that may be improved with SNM therapy include:
InterStim therapy is not intended to treat or be used by people who have:
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Sacral nerve stimulation is only effective for a certain number of individuals. Percutaneous nerve evaluation (PNE) is a diagnostic test undertaken to discern who is a good candidate for InterStim. PNE testing is done under local anesthesia.
PNE has a 50 percent rate of false negative results due to electrode migration which can be detected subjectively by changing the type and location of stimulation and objectively by using radiography.
A staged test trial is the other type of diagnostic exam undertaken to detect PNE. In a staged test trial, a tined electrode is surgically implanted to mitigate the risk of electrode migration. The patient undergoes the test for 14 days (2 weeks) which runs the risk of wound infection. This evaluative test requires 2 surgeries and can be cost prohibitive.
Effectiveness of InterStim
As with any therapy, individual results vary from person to person and case to case. Many individuals implanted with an InterStim device are relieved of many of their painful and uncomfortable symptoms and can experience a greater quality of life.
There are relatively few side effects of InterStim. Common side effects include:
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