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Related Experiment Video

Updated: Jun 30, 2026

Urinary Bladder Distention Evoked Visceromotor Responses as a Model for Bladder Pain in Mice
11:46

Urinary Bladder Distention Evoked Visceromotor Responses as a Model for Bladder Pain in Mice

Published on: April 27, 2014

Sacral Neuromodulation Test-Phase Success in Bladder Pain Syndrome: Systematic Review and Meta-Analysis.

Sagar Yadav1, Aarti Sharma2, Aakash Yadav3

  • 1Department of Urology, All India Institute of Medical Sciences (AIIMS) Bhopal, Madhya Pradesh, India. neelaqua74@gmail.com.

International Urogynecology Journal
|June 29, 2026
PubMed
Summary

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Approximately two-thirds of patients with refractory interstitial cystitis/bladder pain syndrome (IC/BPS) successfully transitioned from sacral neuromodulation (SNM) test stimulation to permanent implantation. Staged tined-lead testing showed higher conversion rates than percutaneous nerve evaluation (PNE).

Area of Science:

  • Urology
  • Neurology
  • Pain Management

Background:

  • Refractory interstitial cystitis/bladder pain syndrome (IC/BPS) presents a significant clinical challenge.
  • Sacral neuromodulation (SNM) is a treatment option, involving a two-stage process: test stimulation (stage 1) followed by permanent implantation (stage 2).
  • Conversion rates from SNM stage 1 to stage 2 and comparisons between different testing methods like percutaneous nerve evaluation (PNE) and staged tined-lead testing are not consistently reported.

Purpose of the Study:

  • To systematically review and meta-analyze the conversion rates from SNM stage 1 to stage 2 in adult patients with refractory IC/BPS.
  • To compare the efficacy of PNE versus staged tined-lead testing in predicting successful SNM implantation for IC/BPS.

Main Methods:

  • A systematic review and meta-analysis were conducted following PRISMA guidelines.
Keywords:
Bladder pain syndromeInterstitial cystitisPercutaneous nerve evaluationSacral neuromodulationSystematic reviewTined lead

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  • Searches were performed on MEDLINE, Embase, and Web of Science.
  • Eligible studies included adult IC/BPS cohorts undergoing SNM testing via PNE or staged tined quadripolar leads.
  • Random-effects meta-analysis of proportions was used, with subgroup and meta-regression analyses.

    • Main Results:

    • The pooled conversion rate from SNM test stimulation to permanent implantation across 1087 patients was 64% (95% CI 55-72%).
    • Conversion rates differed significantly between testing strategies: 53% for PNE (95% CI 46-59) versus 75% for staged tined-lead trials (95% CI 60-86).
    • Clinical cohorts using staged leads showed higher conversion (79.1%) than administrative/claims cohorts (44.6%), with administrative data associated with lower progression odds.

    Conclusions:

    • Approximately two-thirds of patients with refractory IC/BPS progress to permanent SNM implantation after a successful test phase.
    • Staged tined-lead SNM testing demonstrated higher conversion rates compared to historical conventional PNE cohorts.
    • Future research should focus on standardized success criteria and prospective, stratified studies to optimize SNM trial strategy selection for IC/BPS.