Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction

Abstract. Background. Limited published data exist regarding the utility of sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction (NLUTD), consisting of only small case series, and, to our knowledge, no Australian data have been published. The aim of this study was to evaluate...

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Main Authors: Cecile T. Pham, Cameron J. Parkin, James Kovacic, Siying Yeow, Yunzhi Yang, Danielle Delaney, Amanda Chung
Format: Article
Language:English
Published: Wolters Kluwer Health 2025-07-01
Series:Current Urology
Online Access:http://journals.lww.com/10.1097/CU9.0000000000000201
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author Cecile T. Pham
Cameron J. Parkin
James Kovacic
Siying Yeow
Yunzhi Yang
Danielle Delaney
Amanda Chung
author_facet Cecile T. Pham
Cameron J. Parkin
James Kovacic
Siying Yeow
Yunzhi Yang
Danielle Delaney
Amanda Chung
author_sort Cecile T. Pham
collection DOAJ
description Abstract. Background. Limited published data exist regarding the utility of sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction (NLUTD), consisting of only small case series, and, to our knowledge, no Australian data have been published. The aim of this study was to evaluate the clinical outcomes of SNM for treatment of NLUTD in Australian patients. Methods. A retrospective analysis was conducted of patients who received a permanent SNM implant between December 2014 and March 2021. Patients completed a urodynamic test preoperatively. They completed a 3-day bladder diary, uroflowmetry, and postvoid residual measurement preoperatively and at 6-month intervals postoperatively following SNM insertion. Urinary function, patient-reported outcome measures, and adverse events were assessed. Results. A total of 36 patients received a permanent SNM implant. The mean duration of follow-up was 25 ± 20 months, with the majority (89%, n = 32) of patients reporting a >50% improvement on bladder diary evaluation. There was a significant increase in void volume (p < 0.001), decrease in postvoid residual (p < 0.001), decrease in voiding frequency (p < 0.001), decrease in incontinence episodes (p = 0.002), and decrease in pad number (p < 0.001). There was no significant difference in peak flow (p = 0.21). There was no significant difference in SNM efficacy between patients with progressive or nonprogressive neurological conditions. Conclusions. Sacral neuromodulation is a safe and effective therapy for NLUTD in the context of both progressive and nonprogressive neurological conditions. It should be offered more readily to patients with NLUTD as a minimally invasive treatment option with the potential to make clinically meaningful improvements in quality of life.
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spelling doaj-art-111e7cd21165477fbcf8946b60cf14b32025-08-20T02:56:23ZengWolters Kluwer HealthCurrent Urology1661-76492025-07-0119428028510.1097/CU9.0000000000000201202507000-00009Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunctionCecile T. Pham0Cameron J. Parkin1James Kovacic2Siying Yeow3Yunzhi Yang4Danielle Delaney5Amanda Chung6a North Shore Urology Research Group, St Leonards, New South Wales, Australiaa North Shore Urology Research Group, St Leonards, New South Wales, Australiaa North Shore Urology Research Group, St Leonards, New South Wales, Australiaa North Shore Urology Research Group, St Leonards, New South Wales, Australiad Department of Urology, North Shore Private Hospital, St Leonards, New South Wales, Australiaa North Shore Urology Research Group, St Leonards, New South Wales, Australiaa North Shore Urology Research Group, St Leonards, New South Wales, AustraliaAbstract. Background. Limited published data exist regarding the utility of sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction (NLUTD), consisting of only small case series, and, to our knowledge, no Australian data have been published. The aim of this study was to evaluate the clinical outcomes of SNM for treatment of NLUTD in Australian patients. Methods. A retrospective analysis was conducted of patients who received a permanent SNM implant between December 2014 and March 2021. Patients completed a urodynamic test preoperatively. They completed a 3-day bladder diary, uroflowmetry, and postvoid residual measurement preoperatively and at 6-month intervals postoperatively following SNM insertion. Urinary function, patient-reported outcome measures, and adverse events were assessed. Results. A total of 36 patients received a permanent SNM implant. The mean duration of follow-up was 25 ± 20 months, with the majority (89%, n = 32) of patients reporting a >50% improvement on bladder diary evaluation. There was a significant increase in void volume (p < 0.001), decrease in postvoid residual (p < 0.001), decrease in voiding frequency (p < 0.001), decrease in incontinence episodes (p = 0.002), and decrease in pad number (p < 0.001). There was no significant difference in peak flow (p = 0.21). There was no significant difference in SNM efficacy between patients with progressive or nonprogressive neurological conditions. Conclusions. Sacral neuromodulation is a safe and effective therapy for NLUTD in the context of both progressive and nonprogressive neurological conditions. It should be offered more readily to patients with NLUTD as a minimally invasive treatment option with the potential to make clinically meaningful improvements in quality of life.http://journals.lww.com/10.1097/CU9.0000000000000201
spellingShingle Cecile T. Pham
Cameron J. Parkin
James Kovacic
Siying Yeow
Yunzhi Yang
Danielle Delaney
Amanda Chung
Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction
Current Urology
title Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction
title_full Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction
title_fullStr Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction
title_full_unstemmed Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction
title_short Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction
title_sort sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction
url http://journals.lww.com/10.1097/CU9.0000000000000201
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