Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction

Area of Science:

• Urology
• Neurology
• Rehabilitation Medicine

Background:

• Neurogenic lower urinary tract dysfunction (NLUTD) significantly impacts patients with neurological conditions.
• Sacral neuromodulation (SNM) is a potential treatment option for NLUTD.
• Limited data exists on SNM's efficacy in diverse NLUTD etiologies.

Purpose of the Study:

• To evaluate the effectiveness and outcomes of sacral neuromodulation (SNM) in patients with neurogenic lower urinary tract dysfunction (NLUTD).
• To assess the impact of SNM on voiding frequency, pad usage, and post-void residual urine in NLUTD patients.

Main Methods:

• Retrospective chart analysis of 50 patients with NLUTD treated with SNM between 2007 and 2013.
• Evaluation of treatment outcomes, complications, and urodynamic parameters before and during SNM therapy.
• Inclusion criteria focused on patients undergoing SNM for NLUTD at a spinal cord injury rehabilitation center.

Main Results:

• SNM was used in 32 patients, with 94% reporting satisfaction.
• Significant reductions in voiding frequency (9 to 6/24h) and pad use (2.6 to 0.6/24h) were observed in patients with detrusor overactivity.
• Median post-void residual urine significantly decreased from 370 to 59 ml in patients with chronic neurogenic urinary retention.

Conclusions:

• Sacral neuromodulation (SNM) is a viable therapeutic option for carefully selected NLUTD patients.
• Urodynamic evaluation prior to SNM is crucial for patient selection.
• SNM may not be effective in significantly suppressing neurogenic detrusor overactivity (NDO).