Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction

Area of Science:

• Urology
• Neurology
• Medical Devices

Background:

• Limited data exist on sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction (NLUTD).
• No Australian data have been published on SNM for NLUTD.
• This study evaluates SNM's clinical outcomes in Australian NLUTD patients.

Purpose of the Study:

• To assess the effectiveness of sacral neuromodulation (SNM) for treating neurogenic lower urinary tract dysfunction (NLUTD).
• To evaluate clinical outcomes in Australian patients undergoing SNM for NLUTD.

Main Methods:

• Retrospective analysis of 36 patients receiving permanent SNM implants (December 2014 - March 2021).
• Preoperative urodynamic testing, 3-day bladder diaries, uroflowmetry, and postvoid residual measurements.
• Postoperative assessments at 6-month intervals evaluating urinary function, patient-reported outcomes, and adverse events.

Main Results:

• 89% of patients reported >50% improvement in bladder diary evaluations after a mean follow-up of 25 months.
• Significant improvements observed in void volume, postvoid residual, voiding frequency, incontinence episodes, and pad usage (p < 0.001).
• No significant difference in peak flow or SNM efficacy between progressive and nonprogressive neurological conditions.

Conclusions:

• Sacral neuromodulation (SNM) is a safe and effective treatment for neurogenic lower urinary tract dysfunction (NLUTD).
• SNM demonstrates efficacy in both progressive and nonprogressive neurological conditions.
• SNM should be more readily considered for NLUTD patients as a minimally invasive option for improving quality of life.