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Factors Contributing to Sacral Neuromodulation Revision: A Single-Center Study.

Rijul Nanda¹, Annie Chen², Natalia Hernandez²

¹Texas A&M University School of Engineering Medicine, Houston, TX, USA. rijulnanda@tamu.edu.

International Urogynecology Journal

|November 10, 2025

Summary

Sacral neuromodulation (SNM) revision rates were 22%, lower than previously reported. Factors like weight loss and older age were linked to complications requiring revision.

Keywords:

Overactive bladder Sacral neuromodulation Urge urinary incontinence Urinary incontinence

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Area of Science:

Urology
Neuromodulation
Surgical Outcomes

Background:

Sacral neuromodulation (SNM) effectively treats overactive bladder, urinary retention, and fecal incontinence.
High SNM revision rates (up to 39%) necessitate understanding predictors for complications.
Factors influencing SNM revisions and complications remain incompletely understood.

Purpose of the Study:

To characterize reasons for SNM revision over an 18-month period.
To identify potential predictors of SNM revision and associated complications.
To evaluate the effectiveness of antimicrobial envelopes in reducing SNM complications.

Main Methods:

Retrospective chart review of 127 patients undergoing SNM implantation.
Analysis of patient characteristics, procedural details, and reasons for revision.
Complications defined as lead migration, infection, pain, or implantable pulse generator (IPG) issues.

Main Results:

The overall SNM revision rate was 22% (30/135), with a 6.7% explantation rate (9/135).
Primary revision reasons included lead migration (7), no efficacy (8), and desire for MRI-compatible device (7).
Complications were associated with lower BMI (p=0.05) and older age (p=0.007) at revision.

Conclusions:

SNM revision rates were lower than previously published literature.
Weight loss and older age correlated with increased complications requiring revision.
Antimicrobial envelopes did not impact complication rates; their use warrants cost-benefit consideration.