Does sacral neuromodulation with the InterStim device improve symptoms of overactive bladder?

This study looked at the use of sacral neuromodulation (SNM) with the InterStim device in patients with overactive bladder (OAB). It found that SNM improved the symptoms of OAB over 3 years. 

OAB is a condition in which the bladder contracts involuntarily leading to a sudden, urgent need to urinate. Medications can be used to treat OAB. However, these medications are commonly associated with side effects. 

SNM is a treatment for OAB that involves implanting a device below the skin of the buttock, with a wire that travels to the nerves controlling the bladder. This device is designed to stop the bladder contract at the wrong times and improve symptoms of OAB. It is not clear if SNM is an effective treatment for OAB.

190 patients with OAB participated in this study. All had a sacral SNM device (the InterStim device) implanted. 139 patients had a new device implanted (group 1) and 51 had a replacement device (group 2). Patients' OAB symptoms were assessed at the start of the study, and at 4 more visits over the following 3 years.

All patients had significantly fewer urinations per day after SNM device implantation at all follow-up time points. On average, the treatment continued working in 72% of patients in group 1 and 86% of group 2 3 years after implantation. After 34 months, patients needed to urinate an average of 9 times per day, compared to 12 times per day before treatment. The number of episodes of urine leakage decreased from an average of 5 per day before treatment, to 2 episodes per day at 34 months.

49% of patients experienced a problem relating to the device or the implantation procedure. Most of these issues were minor and included pain at the implant site, infection, or battery-related problems.

This study showed that sacral neuromodulation is an effective treatment for OAB.  

This study was funded by Medtronic, the company that produces the InterStim SNM device.