Sacral Neuromodulation Treatment for Non-neurogenic Urological Disorders: Experience of a Single Center in Turkey

What's known on the subject? and What does the study add? Sacral neuromodulation (SNM) has been proven by many studies to be an effective and safe minimal invasive therapy for the treatment of overactive bladder, bladder pain syndrome/interstitial cystitis, and idiopathic non-obstructive urinary retention. Efficacy and safety results of this study is similar with the literature. On the other hand, this study is presenting the experience of a center in Turkey with regard to SNM treatment in non-neurogenic urological disorders. Objective: We evaluated the success rate and complications of sacral neuromodulation (SNM) in patients with non-neurogenic urological disorders. Materials and Methods: We retrospectively evaluated patients with an overactive bladder (OAB), bladder pain syndrome/interstitial cystitis (BPS/ IC), and idiopathic non-obstructive urinary retention (IUR), who underwent SNM between 2015 and 2020. SNM was recommended for patients with OAB and BPS/IC who previously had unsuccessful conservative and medical therapies and botulinum toxin injections. Success was defined as more than 50% improvement in clinical symptoms or voiding diary parameters in patients with OAB; more than 50% improvement in storage symptoms or subjective pain improvement or improvement after pain medications in patients with BPS/IC; more than 50% reduction in urethral catheterization rate in patients with IUR. We reviewed the success rates and complications. Results: Twenty-four patients underwent the first stage of SNM and 16 patients (66.6%) received permanent implantation. Ten patients were female (62.5%) and six were male (37.5%). The mean age was 36.9 years. Seven patients (43.7%) had OAB, three patients (18.7%) had BPS/IC, and six patients (37.5%) had IUR. After a mean follow-up of 42.3 months, the overall success rate was 87.5% for all indications. The success rate was 100%, 100%, and 66.7% for OAB, BPS/IC, and IUR, respectively. Four patients underwent surgical reintervention: two had their devices removed due to failure (50%), one had their implantable pulse generator (IPG) repositioned due to serious pain (25%), and one changed IPG due to malfunction (25%). Conclusion: SNM is a safe and effective minimally invasive therapy for patients with non-neurogenic urological disorders. Keywords: Bladder pain syndrome, idiopathic urinary retention, interstitial cystitis, overactive bladder, sacral neuromodulation