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Reprogramming Sacral Neuromodulation for Sub-Optimal Outcomes: Evidence and Recommendations for Clinical Practice.

Thomas C Dudding1, Paul A Lehur2, Michael Sørensen3

  • 1Pelvic Floor Unit, University Hospital Southampton NHS Foundation Trust, Southampton, UK.

Neuromodulation : Journal of the International Neuromodulation Society
|July 15, 2021
PubMed
Summary
This summary is machine-generated.

Troubleshooting sacral neuromodulation (SNM) involves reprogramming the device to address symptom persistence or side effects. This guide offers practical solutions for sub-optimal outcomes, improving patient satisfaction with SNM therapy.

Keywords:
Fecal incontinencereprogrammingsacral neuromodulationtroubleshootingurinary incontinence

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Area of Science:

  • Urology
  • Neurology
  • Medical Devices

Background:

  • Sacral neuromodulation (SNM) is used for urinary and fecal incontinence.
  • Some patients experience persistent symptoms, reduced efficacy, or adverse effects.
  • Hardware failure can also occur with SNM devices.

Purpose of the Study:

  • To provide practical guidance for troubleshooting sub-optimal outcomes in SNM therapy.
  • To offer solutions for issues like reduced efficacy and adverse stimulation effects.
  • To address hardware failure scenarios in SNM.

Main Methods:

  • A systematic literature review was conducted.
  • Expert multidisciplinary group clinical experience was utilized.
  • Guidance was developed by a group of European experts.

Main Results:

  • Reprogramming strategies include adjusting electrode configuration, stimulation amplitude, pulse frequency, and pulse width.
  • Guidance is provided for managing loss of efficacy and adverse stimulation effects.
  • Management strategies for various hardware failure scenarios are described.

Conclusions:

  • Reprogramming aims to improve patient symptoms and ensure comfortable therapy delivery.
  • Initial reprogramming steps can be performed at home, reducing hospital visits.
  • A logical, stepwise approach to reprogramming enhances outcomes and patient satisfaction.