Sacral neuromodulation for refractory lower urinary tract dysfunctions: a single-center retrospective cohort study

ABSTRACT
Objective. Sacral neuromodulation (SNM) is a technique that electrically stimulates the third sacral spinal nerve root to modulate a neural pathway. In this study, we present our 7‐years’ experience outcomes and complications of SNM in lower urinary tract dysfunctions.
Materials and Methods. We performed a single‐center retrospective cohort study of all patients who underwent InterStim Medtronic SNM device implantation for lower urinary tract dysfunction. All procedures were performed between January 2014 and November 2021 in the Urogynecologycal Center of Villa Sofia Hospital in Palermo by a single expert team. We included 68 patients with refractory lower urinary tract dysfunction who did not adequately respond to primary therapeutical strategies.
Results. We observed a reduction rate of catheterization from a mean of 4.05 to 1.22. In addition, the amount of post-voidal residual decreased from a mean of 520 ml to 187 ml. Among the 41 women in the overactive bladder group, only 36 were included in the follow-up; 24 of the 36 patients (66.6%) had no episodes of leaks; the remaining patients (33.4%) had a significant reduction of leaks. We also recorded a significant reduction in urinary frequency: voids per day decreased from 16.1 at baseline to 6.1. Among the 7 women with BPS, only 5 patients (71.42%) completed the follow-up protocol. They reported satisfaction from the treatment: no patients chronically used pain drugs, and only 1 used occasionally painkillers.
Conclusions. SNM treatment has been found as a potential effective and feasible option for urogynecologycal disorders.