Sacral Neuromodulator Surgery: Is There an Ideal Candidate?

Area of Science:

• Urology
• Neuromodulation
• Medical Devices

Background:

• Sacral neuromodulation (SNM) is an advanced treatment for refractory overactive bladder (OAB) and underactive bladder (UAB).
• The SNM procedure involves two stages: temporary testing followed by permanent implantation for suitable candidates.

Purpose of the Study:

• To evaluate the overall effectiveness of SNM in patients with OAB and UAB.
• To identify correlations between patient demographics, clinical characteristics, and SNM procedural outcomes.
• To examine factors influencing patient-reported satisfaction after SNM implantation.

Main Methods:

• Retrospective analysis of 47 patients who underwent SNM between 2019 and 2024.
• Collected data included demographics, intraoperative variables, and success rates.
• Compared baseline symptoms with post-implantation symptoms for OAB and UAB groups.

Main Results:

• 79% proceeded to permanent SNM, with a 68% success rate.
• 88% of patients with permanent SNM reported satisfaction (average 71%).
• Significant reductions observed in catheterization, pad use, urinary frequency, and nocturia for both UAB and OAB groups. No patient characteristics predicted success.

Conclusions:

• SNM is effective for OAB and UAB, improving quality of life and patient satisfaction.
• Most device removals were due to lack of efficacy after the initial stage.
• Limited predictive value of demographics and intraoperative parameters highlights the need for improved patient selection and counseling.