Refractory Sexual Arousal Subsequent to Sacral Neuromodulation

Area of Science:

• Neuroscience
• Urology
• Sexual Medicine

Background:

• Sacral neuromodulation is a common treatment for lower urinary tract symptoms.
• It is known to improve sexual function, particularly arousal and desire.
• Increased arousal symptoms have not been previously reported as an adverse effect.

Observation:

• A case report of a 57-year-old woman is presented.
• She developed symptomatic persistent genital arousal after sacral neuromodulator implantation.
• Symptoms persisted despite device reprogramming, deactivation, and removal.

Findings:

• The patient experienced markedly increased and persistent genital arousal.
• This may be due to altered sacral nerve pathway activation.
• This is the first reported case of hyperarousal as an adverse effect of sacral neuromodulation, persisting post-removal.

Implications:

• Sacral neuromodulation may have previously unrecognized adverse effects on sexual function.
• Clinicians should be aware of potential hyperarousal symptoms.
• Further research is needed to understand the mechanisms and prevalence.