Long-term outcomes for sacral neuromodulation for lower urinary tract dysfunction.

This trial looked at the long-term outcomes of sacral neuromodulation (SNM) for patients with overactive bladder (OAB). The authors found that SNM was a minimally invasive procedure with good long-term success rates. 

SNM one of several treatment options for the symptoms of OAB, retention and voiding issues (RV), bladder pain syndrome (BPS), and neurogenic lower urinary tract dysfunction (NLUTD). It is a reversible treatment that uses a small device to send electrical impulses to nerves located in the lower back. Stimulation of these sacral nerves can often stop or reduce bladder control issues in patients. Previous studies have not reported long-term outcomes for patients who underwent an SNM procedure. 

A total of 434 patients underwent testing for SNM device implantation. Of these, 241 patients received the SNM device implantation. The average length of follow-up for patients was 4 years. 

Overall, 60% of patients reported symptom improvements. In patients with OAB, 50% reported symptom improvement. In patients with RV, 80% reported symptom improvement. In patients with BPS, 60% reported symptom improvement. In patients with NLUTD, 35% reported symptom improvement. 

For patients who still had the device implanted at the last follow-up, the average symptom resolution was 75%. 69.3% of patients who underwent SNM device implant had at least 1 re-intervention. Patients had a lead change or replacement procedure in 51.25%  of cases. The average length of time that patients had before battery replacement was required was 8.4 years.

The authors concluded that SNM resulted in good long-term outcomes in patients with bladder control issues. 

This study mostly consisted of female patients. This may not translate to a wider population.