Improvement in depression and health-related quality of life after sacral nerve stimulation therapy for treatment of voiding dysfunction

Objectives. To assess depression and health-related quality of life (HROOL) in 89 people with refractory urge incontinence, nonobstructive urinary retention, or urgency frequency enrolled at 13 U.S. study centers. The subjects were part of a large international, multicenter, randomized clinical trial on the safety and efficacy of sacral nerve stimulation for the treatment of refractory voiding dysfunction. Methods. The Beck Depression Index and the Medical Outcomes Study Short-Form 36 were used to assess depression and HROOL at baseline and at two follow-up visits. Results. Detectable levels of depression and reduced quality of life were noted at baseline. Subjects implanted with the stimulation device reported significant improvements in both HRQOL and depression at 3 months after implant that were maintained for the 6-month study period. Subjects assigned to the delayed implant group showed a slight worsening of HROOL and depression from baseline to 3 months that continued through the 6-month visit. Conclusions. The results demonstrated the serious impact that unresolved voiding symptoms have on the physical, social, and psychological dimensions of quality of life. Treating refractory voiding dysfunction with sacral nerve stimulation resulted in improvement in both depression and HRQOL. (C) 2004 Elsevier Inc.