Sacral neuromodulation and female sexuality

Area of Science:

• Urology
• Neuroscience
• Sexual Medicine

Background:

• Sacral neuromodulation (SNM) is an implantable device primarily used for urinary and fecal incontinence.
• The impact of SNM on female sexual function (FSF) requires further investigation.
• Existing research presents varied outcomes regarding SNM's effect on FSF.

Purpose of the Study:

• To conduct an up-to-date review of the impact of permanent sacral neuromodulation (SNM) implants on female sexual function (FSF).
• To synthesize findings from clinical studies evaluating SNM's efficacy and safety concerning FSF.

Main Methods:

• A systematic review of clinical studies published between January 2001 and February 2014.
• Studies focused on the impact and/or safety of permanent SNM implants on FSF.
• Nine studies were selected, with most participants being menopausal women, often treated for overactive bladder or fecal incontinence.

Main Results:

• Most women experienced statistically significant improvements in at least one domain of the Female Sexual Function Index (FSFI) post-SNM.
• Improvements in the FSFI pain domain were noted specifically in women with neurological conditions.
• However, two studies found no significant differences in sexual function screening, and severe issues like loss of libido were resolved only after device removal in one case.

Conclusions:

• Current evidence is insufficient to definitively conclude that SNM positively impacts female sexual function.
• Further research is needed to clarify the relationship between SNM and FSF.
• The heterogeneity of studies and patient populations limits conclusive findings.