{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T01:40:34Z","timestamp":1790732434955,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T00:00:00Z","timestamp":1677283200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurourology and Urodynamics"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction\/Background<\/jats:title><jats:p>The pulse width (PW) parameter in sacral neuromodulation (SNM) is understudied, with no evidence\u2010based guidance available on optimal PW for urinary indications. The aim of this prospective, randomized, single\u2010blinded, 3\u2009\u00d7\u20093 cross over design study was to estimate the effect of two PW settings (60\u2009\u00b5s, 420\u2009\u00b5s) compared to the industry standard (210\u2009\u00b5s) on SNM efficacy, quality of life, and device parameters in patients who were stable and satisfied with their SNM treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods\/Materials<\/jats:title><jats:p>Eligible patients were previously implanted and had urge incontinence or urgency\u2010frequency with satisfaction on SNM at time of enrollment. Patients completed a 3\u2010day voiding diary, validated questionnaires, and device interrogations with sensory threshold assessment at baseline and after a 4\u2010week period on each of the three PW settings, to which they were randomized. Eighteen participants completed the study, as called for by power analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighteen patients were enrolled in the study. Mean age was 68 years and implant duration at the time of participation was 4.4 years. While PW variations did not produce significant differences in overall objective outcomes, device parameters, including sensory threshold amplitude and battery life differed significantly. Shortened PW necessitated higher amplitude while conserving battery life. Stimulus sensation location, quality, and intensity did not differ between PW. Standard PW was chosen by 11 patients after the study, 5 chose extended, and 2 chose shortened. Those who chose alternative PW achieved significant reductions in urinary frequency from enrollment \u22122.23 voids\/day (<jats:italic>p<\/jats:italic>\u2009=\u20090.015). Upon sub\u2010analysis, patients reporting \u201cmuch better\u201d or \u201cvery much better\u201d on extended PW achieved significant reductions in urinary frequency and nocturia at 5.6 and 0.4, compared to 8.5 and 2.16 at baseline (<jats:italic>p<\/jats:italic>\u2009=\u20090.005, <jats:italic>p<\/jats:italic>\u2009=\u2009&lt;0.001). Whereas those reporting \u201cmuch better\u201d or \u201cvery much better\u201d on shortened PW achieved significant reductions in urinary frequency at 5.15 compared to 7.35 (<jats:italic>p<\/jats:italic>\u2009=\u20090.026). There were no adverse events or complications.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall SNM effectiveness was unchanged with alternative PW; however, 39% of patients preferred alternative to standard PW and achieved significant improvements in urinary symptoms with such. Shorter PW can also provide savings in estimated battery life without sacrificing therapeutic efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/nau.25161","type":"journal-article","created":{"date-parts":[[2023,2,25]],"date-time":"2023-02-25T16:09:15Z","timestamp":1677341355000},"page":"770-777","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Effect of pulse width variations on sacral neuromodulation for overactive bladder symptoms: A prospective randomized crossover feasibility study"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7001-9933","authenticated-orcid":false,"given":"Jessica","family":"Rueb","sequence":"first","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howard B.","family":"Goldman","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Cleveland Ohio USA"},{"name":"Lerner College of Medicine, Education Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8626-8248","authenticated-orcid":false,"given":"Sandip","family":"Vasavada","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Cleveland Ohio USA"},{"name":"Lerner College of Medicine, Education Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtenay","family":"Moore","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Cleveland Ohio USA"},{"name":"Lerner College of Medicine, Education Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Rackley","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Cleveland Ohio USA"},{"name":"Lerner College of Medicine, Education Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley C.","family":"Gill","sequence":"additional","affiliation":[{"name":"Glickman Urological and Kidney Institute Cleveland Clinic Cleveland Ohio USA"},{"name":"Lerner College of Medicine, Education Institute Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,2,25]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/nau.23515"},{"key":"e_1_2_11_3_1","unstructured":"Medtronic Inc.InterStim Model 8870 Programming Guide for Software Version B:User Manual.\u00a02016.\u00a0Retrieved from:https:\/\/manuals.medtronic.com\/content\/dam\/emanuals\/neuro\/CONTRIB_243373.pdf"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2018.04.019"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11695-016-2238-5"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.4103\/1673-5374.274326"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brs.2017.11.007"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1350-4533(99)00074-0"},{"issue":"6","key":"e_1_2_11_9_1","first-page":"545","article-title":"Selective and graded recruitment of cat hamstring muscles with intrafascicular stimulation","volume":"17","author":"Dowden BR","year":"2009","journal-title":"IEEE Trans Biomed Eng"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1109\/10.481985"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.5213\/inj.1938042.021"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12710"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12779"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-018-0837-5"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","unstructured":"DuddingT BradshawE BuntzenS LundbyL LaurbergS VaizeyC. 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