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Sacral Neuromodulation in Non-Obstructive Urinary Retention and Painful Bladder Syndrome: an Update

  • Post-Prostatectomy and Acquired Voiding Dysfunction (V Tse, Section Editor)
  • Published:
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Abstract

Sacral neuromodulation (SNM) is an established treatment option for several urologic conditions, and its use continues to grow. Indications and applications for SNM are expanding as our understanding of its mechanism of action improves, and our experience develops. Current urologic applications include overactive bladder (OAB), non-obstructive urinary retention, and pelvic pain disorders. SNM has become an established therapeutic modality for non-obstructive urinary retention, while SNM for pelvic pain disorders has found a place in accepted treatment guidelines. This review provides an update on SNM and focuses on developments in SNM relating to the less-studied applications of non-obstructive urinary retention and painful bladder syndrome.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Schmidt RA, Bruschini H, Tanagho EA. Sacral root stimulation in controlled micturition. Peripheral somatic neurotomy and voiding. Invest Urol. 1979;17:130–4.

    CAS  PubMed  Google Scholar 

  2. Chartier-Kastler E. Sacral neuromodulation for treating the symptoms of overactive bladder syndrome and non-obstructive urinary retention: >10 years of clinical experience. BJU Int. 2008;101:417–23.

    Article  PubMed  Google Scholar 

  3. Gupta P, Ehlert MJ, Sirls LT, et al. Percutaneous tibial nerve stimulation and sacral neuromodulation: an update. Curr Urol Rep. 2015;16:1–6.

    Article  Google Scholar 

  4. Vasavada SP, Rackley RR. Electrical stimulation and neuromodulation in storage and emptying failure. In: Kavoussi LR, Partin AW, Novick AC, et al., editors. Campbell-Walsh Urology, Vol 3. 10th ed. Philadelphia: Saunders; 2012. Chap 70.

    Google Scholar 

  5. Spinelli M, Weil E, Ostardo E, et al. New tined lead electrode in sacral neuromodulation: experience from a multicenter European study. World J Urol. 2005;23:225–9.

    Article  PubMed  Google Scholar 

  6. Leong RK, De Wachter SGG, Nieman FHM, et al. PNE versus 1st stage tined lead procedure: a direct comparaison to select the most sensitive test method to identify patients suitable for sacral neuromodulation therapy. Neurourol Urodyn. 2011;30:1249–52.

    PubMed  Google Scholar 

  7. Spinelli M, Giardiello G, Gerber M, et al. New sacral neuromodulation lead for percutaneous implantation using local anesthesia: description and first experience. J Urol. 2003;170:1905–7.

    Article  PubMed  Google Scholar 

  8. Comiter CV. Sacral nerve stimulation to treat nonobstructive urinary retention in women. Curr Urol Rep. 2008;9:405–11.

    Article  PubMed  Google Scholar 

  9. Fowler CJ, Christmas TJ, Chapple CR, et al. Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome? Br Med J. 1988;297:1436–8.

    Article  CAS  Google Scholar 

  10. Jonas U, Fowler CJ, Chancellor MB, et al. Efficacy of sacral nerve stimulation for urinary retention: results 18 months after implantation. J Urol. 2001;165:15–9.

    Article  CAS  PubMed  Google Scholar 

  11. Hassouna M, Shaker HS. Sacral root neuromodulation in idiopathic nonobstructive chronic urinary retention. J Urol. 1998;159:1476–8.

    Article  PubMed  Google Scholar 

  12. DasGupta R, Fowler CJ. The management of female voiding dysfunction: Fowler’s syndrome—a contemporary update. Curr Opin Urol. 2003;13:293.

    Article  PubMed  Google Scholar 

  13. DasGupta R, Critchley HD, Dolan RJ, et al. Changes in brain activity following sacral neuromodulation for urinary retention. J Urol. 2005;174:2268–72.

    Article  PubMed  Google Scholar 

  14. Gross C, Habli M, Lindsell C, et al. Sacral neuromodulation for nonobstructive urinary retention: a meta-analysis. Female Pelvic Med Reconstr Surg. 2010;16:249–53.

    Article  PubMed  Google Scholar 

  15. Peeters K, Sahai A, De Ridder D, et al. Long-term follow-up of sacral neuromodulation for lower urinary tract dysfunction. BJU Int. 2014;113:789–94. Retrospective review presenting long-term follow-up data on SNM for non-obstructive urinary retention. Success rate (>50 % reduction in ISC) was seen in 73 %, while cure (100 % reduction in ISC) was seen in 62.5 % and 53 % for Fowler’s syndrome, and idiopathic urinary retention, respectively.

    Article  PubMed  Google Scholar 

  16. Al-Zahrani AA, Elzayat EA, Gajewski JB. Long-term outcome and surgical interventions after sacral neuromodulation implant for lower urinary tract symptoms: 14-year experience at 1 center. J Urol. 2011;185:981–6. Long-term review of patients undergoing SNM for voiding dysfunction. Demonstrated that in 16 patients with SNM implantation, an 87.5 % success was obtained.

    Article  PubMed  Google Scholar 

  17. Saber-Khalaf M, Abtahi B, Gonzales G, et al. Sacral neuromodulation outcomes in male patients with chronic urinary retention. Neuromodulation. 2015. doi:10.1111/ner.12268. Review of results of SNM in males with chronic urinary retention that demonstrated an overall 66.7 % success rate.

    PubMed  Google Scholar 

  18. Hanno P, Dmochowski R. Status of international consensus on interstitial cystitis/bladder pain syndrome/painful bladder syndrome: 2008 snapshot. Neurourol Urodyn. 2009;28:274.

    Article  PubMed  Google Scholar 

  19. Hanno PM, Burks DA, Clemens JQ, et al. AUA guideline for the diagnosis and treatment of interstitial cystitis/bladder pain syndrome. J Urol. 2011;185:2162–70.

    Article  PubMed  Google Scholar 

  20. Zabihi N, Mourtzinos A, Maher MG, et al. Short-term results of bilateral S2-S4 sacral neuromodulation for the treatment of painful baldder syndrome, and chronic pelvic pain. Int Urogynecol J. 2008;19:553–7.

    Article  Google Scholar 

  21. Moldwin RM, Evans RJ, Stanford EJ, et al. Rational approaches to the treatment of patients with interstitial cystitis. J Urol. 2007;69:73–81.

    Article  Google Scholar 

  22. Banakhar MA, Al-Shaiji TF, Hassouna M. Sacral neuromodulation in the treatment of interstitial cystitis/painful bladder syndrome: should it be off label? Curr Bladder Dys Rep. 2012;7:120–4.

    Article  Google Scholar 

  23. Bemelmans BL, Mundy AR, Craggs MD. Neuromodulation by implant for treating lower urinary tract symptoms and dysfunction. Eur Urol. 1999;36:81–91.

    Article  CAS  PubMed  Google Scholar 

  24. Peters KM, Carey JM, Konstandt DB. Sacral neuromodulation for the treatment of refractory interstitial cystitis: outcomes based on technique. Int Urogynecol J Pelvic Floor Dysfunct. 2003;14:223–8.

    Article  CAS  PubMed  Google Scholar 

  25. Comiter C. Sacral neuromodulation for the symptomatic treatment of refractory interstitial cystitis: a prospective study. J Urol. 2003;169:1369–73.

    Article  PubMed  Google Scholar 

  26. Powell CR, Kreder KJ. Long-term outcomes of urgency-frequency syndrome due to painful bladder syndrome treated with sacral neuromodulation and analysis of failures. J Urol. 2010;183:173–6.

    Article  PubMed  Google Scholar 

  27. Gakewski JB, Al-Zahrani AA. The long-term efficacy of sacral neuromodulation in the management of intractable cases of bladder pain syndrome: 14 years of experience in one centre. BJU Int. 2011;107:1258–64. Single centre, 14 year experience with SNM for PBS demonstrating a 72 % long-term success rate, but 50 % revision rate.

    Article  Google Scholar 

  28. Marinkovic SP, Gillen LM, Marinkovic CM. Minimum 6-year outcomes for interstitial cystitis treated with sacral neuromodulation. Int Urogynecol J. 2011;22:407–12. Long-term follow up of IC patients treated with SNM showing significantly improved pelvic pain/urgency and visual analog pain scores, with mean follow-up of 86 months.

    Article  PubMed  Google Scholar 

  29. Pham K, Guralnick ML, O’Connor RC. Unilateral versus bilateral stage I neuromodulator treatment of refractory voiding dysfunction. Neurourol Urodyn. 2008;27:779–81.

    Article  PubMed  Google Scholar 

  30. Marcelissen TA, Leong RK, Serroyen J, et al. The use of bilateral sacral nerve stimulation in patients with loss of unilateral treatment efficacy. J Urol. 2011;185:976–80.

    Article  PubMed  Google Scholar 

  31. Scheepens WA, de Bie RA, Weil EHJ, et al. Unilateral versus bilateral sacral neuromodulation in patients with chronic voiding dysfunction. J Urol. 2002;168:2046–50.

    Article  CAS  PubMed  Google Scholar 

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Nathan Hoag and Johan Gani declare that they have no conflict of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Correspondence to Johan Gani.

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This article is part of the Topical Collection on Post-Prostatectomy and Acquired Voiding Dysfunction

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Hoag, N., Gani, J. Sacral Neuromodulation in Non-Obstructive Urinary Retention and Painful Bladder Syndrome: an Update. Curr Bladder Dysfunct Rep 10, 303–307 (2015). https://doi.org/10.1007/s11884-015-0317-4

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  • DOI: https://doi.org/10.1007/s11884-015-0317-4

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