How effective is neuromodulation to treat unresponsive overactive bladder?

This study investigated the effectiveness of a sacral neuromodulation (SNM) device to treat overactive bladder (OAB) unresponsive to medications. They found that SNM improved OAB symptoms.

Overactive bladder (OAB) is a common condition, especially in the older population. Patients with OAB have a greater urge to urinate. They may also have trouble controlling urination (incontinence). OAB can lead to poor quality of life. 

There are a number of treatment options for OAB. Medications are one option. Another option involves sacral neuromodulation (SNM). It involves placing a device under the skin of the lower back. The SNM device blocks a signal from the sacral nerve to the bladder muscle. The end result is a reduction in the urge to urinate. The BetterStim SNM system is a new type of SNM device. The safety and effectiveness of this SNM device in patients with OAB who do not respond to medications is still under investigation.

This study included 84 patients with OAB. Patients were randomly assigned to either a treatment or a control group. All patients had an SNM device impanted. In the treatment group, the device was switched on immediately. In the control group, the device was switched on 3 months after implantation. Only control patients were allowed to take their OAB medication during the first 3 months. Patients underwent follow-up at 1, 3 and 6 months. 

After the first 3 months, patients in the treatment group had a greater improvement in symptoms compared to the control group (72% vs. 12%). After this follow-up appointment, control patients had their devices switched on. At 6 months all patients had an improvement in OAB symptoms. There was no difference between the two groups at 6 months.

The rate of side effects was 12.86%. These were related to the device. They included pain at the site of implantation or a lack of effectiveness. Lack of effectiveness was resolved after device reprogramming.

The authors concluded that SNM improved OAB symptoms in unresponsive patients.

This was a short-term study. Longer studies are needed to determine if the device is safe and effective. 

If you have any concerns regarding OAB treatment, please consult with your physician.