Sacral neuromodulation in functional urinary retention: an effective way to restore voiding

Area of Science:

• Urology
• Neuromodulation
• Pelvic Floor Dysfunction

Background:

• Functional urinary retention is often idiopathic and challenging to treat.
• Pelvic floor dysfunction is a recognized potential cause of urinary retention.
• Previous therapies, including clean intermittent catheterization, may fail.

Purpose of the Study:

• To evaluate the long-term effectiveness and safety of sacral nerve stimulation (SNS).
• To assess SNS as an alternative therapy for functional unobstructive urinary retention.
• To explore the role of pelvic floor dysfunction in this condition.

Main Methods:

• Twenty patients with refractory urinary retention underwent permanent sacral nerve stimulation implantation.
• A percutaneous nerve evaluation with >50% symptom improvement preceded permanent implantation.
• Patients were monitored for symptom improvement, voided volume, and post-void residual (PVR) volume.

Main Results:

• Eighteen patients achieved spontaneous voiding with increased voided volume (48 to 198 mL) and decreased PVR (315 to 60 mL).
• Eighteen patients reported >=50% symptom improvement and would recommend the therapy.
• Complications were reported in six patients.

Conclusions:

• Sacral nerve stimulation is an effective and durable treatment for functional urinary retention.
• Test stimulation is a useful method for identifying suitable candidates for SNS.
• SNS presents a promising alternative therapy with a manageable complication profile.