Evaluating Decision Regret in Patients Who Have Undergone Sacral Neuromodulation

Urology. 2024 Oct 30:S0090-4295(24)00954-3. doi: 10.1016/j.urology.2024.10.067. Online ahead of print.

Abstract

Objectives: To quantify decision regret in individuals who had undergone sacral neuromodulation (SNM). Secondary objectives evaluated for correlation of subjects' regret score with symptom relief, complications, device explant status, or military deployment status.

Methods: Each subject's decision regret was assessed via a telephone survey utilizing a validated decision regret tool, and regret scores were calculated. A score of 50 was utilized a cutoff, below which patients were deemed to have minimal regret while those scores above 50 were associated with significant decision regret. Comparative statistics were used to identify correlation between regret scores and patient outcomes and military deployment status.

Results: Out of 170 identified subjects, 96 completed the full survey. The mean age of study participants was 49.8 ± 14.5 years, and 58.3% of the participants were female. The average time from implant to survey was 64 months. The mean regret score for patients reporting symptom improvement with the device was 5.4±9.2 (versus 44.1±27.6 for those who did not report symptom improvement, p< 0.001). Regret scores for patients who had device complications were significantly higher than those who did not. At time of survey, 82.3% of subjects had the implant in place. Those subjects who underwent device explant had higher regret scores than those who retained their device.

Conclusions: Decision regret related to SNM appeared low. SNM adverse outcome variables (poor symptom improvement, device complications, and explanted device) were associated with significantly higher decision regret scores than those with more ideal outcomes, but overall decision regret was still low. Military deployment had no correlation with SNM regret.