Implementation of sacral neuromodulation for urinary indications. A Danish prospective study during the initial 15 months of a new service in a tertiary referral hospital

Hanne Kobberø*, Margrethe Andersen, Karin Andersen, Torben Brøchner Pedersen, Mads Hvid Aaberg Poulsen

*Corresponding author for this work

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Objective:
Sacral neuromodulation (SNM) is a well-established treatment modality for idiopathic overactive bladder and urgency incontinence, idiopathic fecal incontinence and non-obstructive urinary retention. This study describes the start-up phase of establishing the SNM service. Primary objective: To investigate the patient-reported outcome measures of SNM on lower urinary tract dysfunction symptoms. Secondary objectives: To investigate bowel function, sexual satisfaction and to monitor SNM safety.
Materials and methods
Twenty-two patients with refractory idiopathic and neurogenic lower urinary tract dysfunction were offered a two-stage test-phase procedure and SNM device implantation. On completing the study, the patients rated their satisfaction with the treatment using a five-point Likert scale and a bother score of urinary, bowel and sexual symptoms on a scale of 1–10 (the worst). Their complications were assessed.
Results
Nineteen patients (86%) were responders during the test phase and had the pulse generator implanted. Seventeen patients were very satisfied/satisfied. A statistically significant change in urinary symptoms bother score was observed in the idiopathic and neurogenic patients, a reduction from 10 to 4 (p = .0057) and 10 to 3 (p = .014), respectively. Eleven patients (58%) had symptoms from two or three pelvic compartments. Nine patients (47%) had complications. All but one event was resolved.
Conclusions
SNM is safe in this heterogeneous group of patients with refractory lower urinary tract dysfunction of various etiologies. A substantial improvement was observed in the pelvic organ dysfunction, demanding a multidisciplinary approach. More studies are required to standardize the evaluation of the subjective and objective outcomes of SNM.
Translated title of the contributionIndførsel af sakral nervemodulation på urologiske indikationer. Et dansk prospektivt studie over de første 15 måneder med en ny behandling på en højtspecialiseret enhed
Original languageEnglish
JournalScandinavian Journal of Urology
Volume56
Issue number5-6
Pages (from-to)404-411
ISSN2168-1805
DOIs
Publication statusPublished - 2022

Keywords

  • Humans
  • Prospective Studies
  • Tertiary Care Centers
  • Electric Stimulation Therapy/adverse effects
  • Urinary Bladder
  • Urinary Bladder, Overactive/therapy
  • Lower Urinary Tract Symptoms/etiology
  • Denmark
  • Treatment Outcome

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