Arlen et al. ( 1313. Arlen AM, Powell CR, Kreder KJ. Sacral neuromodulation for refractory urge incontinence is less effective following spinal surgery. ScientificWorldJournal. 2011;11:142-6. ) LE 4 |
2011 RCS Case-control study |
Patients with or without prior spinal surgery (OAB, NOR) |
32 |
≥ 50% symptom improvement in bladder diaries |
Clinical success achieved in selected patients with LUTS and a history of spinal surgery; urge incontinence less likely to improve. Mean follow-up of 2.3 years; Complications not reported |
Lombardi et al. ( 1414. Lombardi G, Nelli F, Mencarini M, Del Popolo G. Clinical concomitant benefits on pelvic floor dysfunctions after sacral neuromodulation in patients with incomplete spinal cord injury. Spinal Cord. 2011;49:629-36. ) LE 4 |
2011 PCS |
Incomplete spinal cord lesions (OAB and/or NOR) |
75 |
≥ 50% symptom improvement in bladder and bowel diaries |
14/37 (38%) subjects with two functional pelvic dysfunctions maintained notable clinical improvement with a median follow-up >3 years |
Chaabane et al. ( 1515. Chaabane W, Guillotreau J, Castel-Lacanal E, Abu-Anz S, De Boissezon X, Malavaud B, et al. Sacral neuromodulation for treating neurogenic bladder dysfunction: clinical and urodynamic study. Neurourol Urodyn. 2011;30:547-50. ) LE 4 |
2011 RCS |
Various neurological diseases* (OAB in 34, NOR in 15, NOR+DO in 13) |
62* |
Clinical and urodynamic improvement ≥ 50% and symptom recurrence after stopping stimulation |
41 (66.1%) had more than 50% improvement on urodynamic evaluation and bladder diary and 37 were implanted. With a mean follow-up of 4.3 ± 3.7 years, results were maintained in 28 (75.7%). SNM failed on average 12.0 ± 12.4 months after implantation |
Minardi et al. ( 88. Minardi D, Muzzonigro G. Sacral neuromodulation in patients with multiple sclerosis. World J Urol. 2012;30:123-8. ) LE 4 |
2012 RCS |
MS (OAB, NOR) |
25 |
> 50% symptom improvement in bladder diaries and/or >50% decrease in daily catheterizations and increase in voided volumes |
15 (60%) patients received the IPG. After a mean follow-up of 61.2 months, 10 patients still had a functioning device. SNM did not help MS patients with urinary retention due to detrusor underactivity. |
Lansen-Koch et al. ( 1111. Lansen-Koch SM, Govaert B, Oerlemans D, Melenhorst J, Vles H, Cornips E, et al. Sacral nerve modulation for defaecation and micturition disorders in patients with spina bifida. Colorectal Dis. 2012;14:508-14. ) LE 4 |
2012 RCS |
Spina bifida (Fecal or urinary incontinence, constipation, NOR or a combination) |
10 |
≥ 50% symptom improvement |
Only 3/10 (30%) patients succeeded and received the permanent IPG. In one patient the electrode could not be implanted; .one patient developed skin erosion at the stimulator site in the buttock, requiring replacement to the abdomen. |
Groen et al. ( 1616. Groen LA, Hoebeke P, Loret N, Van Praet C, Van Laecke E, Ann R, et al. Sacral neuromodulation with an implantable pulse generator in children with lower urinary tract symptoms: 15-year experience. J Urol. 2012;188:1313-7. ) LE 4 |
2012 RCS |
Spina bifida (Unclear pattern of NLUTD; 2 patients with UI) |
3 |
≥ 50% symptom improvement |
The IPG was removed in all 3 patients due to disappointing results (time from implantation to removal was not reported). |
Peters et al. ( 33. Peters KM, Kandagatla P, Killinger KA, Wolfert C, Boura JA. Clinical outcomes of sacral neuromodulation in patients with neurologic conditions. Urology. 2013;81:738-43. ) LE 4 |
2013 PCS |
NLUTD (Stroke in 17, MS in 13, PD in 10, incomplete SCI in 4, and others) |
71 |
≥ 50% symptom improvement in bladder diaries |
63 of 71 (88.7%) with a neurological disease and 241 of 269 (89.6%) without a neurological disease received the IPG (P = .82). Complications, revisions/explants, and reprogramming sessions were similar in the 2 groups |
Lombardi et al. ( 1717. Lombardi G, Musco S, Celso M, Ierardi A, Nelli F, Del Corso F, et al. Intravesical electrostimulation versus sacral neuromodulation for incomplete spinal cord patients suffering from neurogenic non-obstructive urinary retention. Spinal Cord. 2013;51:571-8. ) LE 4 |
2013 RCS |
Incomplete SCI (ASIA C or D) (NOR) |
77 |
50% reduction of volume per catheterization and number of catheterizations per day |
11/29 patients (31%) reached a BCI > 100. Most voided with Valsalva maneuver, with vesical pressure 72-95cm H20. 10/29 patients became nonresponsive in a mean follow-up of 54 months. |
Andretta et al. ( 1818. Andretta E, Simeone C, Ostardo E, Pastorello M, Zuliani C. Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction. J Neurol Sci. 2014;347:257-61. ) LE 4 |
2014 RCS |
MS (Storage in 41%, voiding in 24%, mixed in 35%) |
17 |
Not stated |
75% had significant and lasting improvement in LUTS and in quality of life. SNM was discontinued after a mean time of 66 months due to disease progression in 2 cases and loss of efficacy in 3. |
Lombardi et al. ( 1919. Lombardi G, Musco S, Celso M, Del Corso F, Del Popolo G. Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: a ten-year follow-up single-centre experience. Spinal Cord. 2014;52:241-5. ) LE 2b |
2014 PCS |
Incomplete SCI (NOR) |
50 |
Concomitant reduction by at least 50% of volume per catheterization and catheterizations per day |
36 patients received the IPG. Significant increase in urinary flow and decrease in residual urine were documented. 11/34 patients at follow-up were ‘inconstant responders’, as they returned to baseline symptoms but responded again with an implant on the contralateral S3. All but one failure occurred more than 3 years after the previous implant. |
Chen et al. ( 2020. Chen G, Liao L. Sacral neuromodulation for neurogenic bladder and bowel dysfunction with multiple symptoms secondary to spinal cord disease. Spinal Cord. 2015;53:204-8. ) LE 4 |
2015 RCS |
Incomplete SCI (Neurogenic bladder and bowel dysfunction) |
23 |
At least 50% clinical improvement (bladder diary, residual volume and the Wexner questionnaire for constipation) |
IPG implanted in 13 (56.5%) patients, including 4 who still used intermittent catheterization. During a mean follow-up of 17.5 months, 1 patient failed and 1 patient developed bilateral vesicoureteral reflux. |
Engeler et al. ( 2121. Engeler DS, Meyer D, Abt D, Müller S, Schmid HP. Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis: a single-centre prospective series. BMC Urol. 2015;15:105. ) LE 4 |
2015 PCS |
MS (OAB, or LUTS caused by detrusor underactivity or detrusor sphincter dyssynergia, or both) |
17 |
>70 % improvement in voiding and storage symptoms on voiding diary |
At 3 years of follow-up, voided volume improved from 125 to 265 mL, post void residual from 170 to 25 mL, micturition frequency from 12 to 7/day and number of UI episodes/day from 3 to 0. Satisfaction was 80%. Loss of clinical benefit in 2 patients; there were no major complications. |
Wöllner et al. ( 2222. Wöllner J, Krebs J, Pannek J. Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54:137-40. ) LE 4 |
2016 RCS |
Various neurological diseases Incomplete SCI in 35 patients (70%) (Neurogenic DO, neurogenic urinary retention) |
50 |
Objective improvement of voiding frequency and daily pad usage, or post-void residual urine. |
IPG implanted in 35 patients (70%). In 26 patients with refractory DO, daily frequency was reduced from 9 to 6, and pad use was improved from 2.6 to 0.6/day; nine patients with NOR had post void residue reduced from 370 to 59 mL; At the last follow-up, SNM was in use in 32 (64%) patients. |
Okafor et al. ( 1212. Okafor H, Gill B, Pizarro-Berdichevsky J, Clifton M, Dielubanza E, Faris A, et al. Sacral Neuromodulation therapy in patients with neurologic lower urinary tract dysfunction - Should it remain an off-labe indication? Analysis of 80 consecutive cases. J Urol. 2016. p. e188. ) LE 4 |
2016 RCS |
Various neurological diseases |
80** |
Not stated |
Progression to stage 2 SNM was 90%. Revision rate=46%; Explantation rate=33% (most common reason was loss of efficacy). |
Greenberg et al. ( 2323. Greenberg, D., Sohlberg, E., Zhang, C., Comiter, C., Enemchukwu, E. Sacral neuromodulation in parkinson’s disease patients with neurogenic bladder. lippincott williams & wilkins.2019:e95. ) LE 4 |
2019 RCS |
Parkinson Disease |
14 |
≥ 50% symptomatic improvement |
IPG implanted in 8 patients. Decreased urinary frequency up to 18 months compared to baseline: 7.70±8 voids/24 hours vs. 15.6±2.2 voids/24 hours (p<0.05). No patients required explantation of their SNM device. |
Sharifiaghdas ( 2424. Sharifiaghdas F. Sacral neuromodulation in congenital lumbo-sacral and traumatic spinal cord defects with neurogenic lower urinary tract symptoms: a single-center experience in children and adolescents. World J Urol. 2019;37:2775-83. ) LE 4 |
2019 RCS |
Spinal dysraphism in 6 and traumatic spinal cord in 2 |
8 |
≥ 50% reduction of UI, in urinary frequency, post-void residual volume and need for intermittent catheterization |
Positive clinical response was achieved in seven (85%) at a mean follow-up of 14.25 months. Three patients became capable to stop clean intermittent catheterization |
Peyronnet et al.( 1010. Peyronnet B, Biardeau X, Cornu J, Vurture G, Hignard Aea. Sacral Neuromodulation in patients with parkinson´s disease a multicenter study. SUFU Abstract Program: Abstract #126. Neurourol Urodyn 2019: S106-7. ) LE 4 |
2019 RCS |
Parkinson´s Disease |
20 |
≥ 50% reduction in storage symptoms |
IPG implanted in 13 patients, 7 patients still presented response at 20-month follow-up. Four explanations of the device were performed due to loss of efficacy (n= 3) and ‘discomfort’ (n=1). |