Sacral neuromodulation for neurological disease-induced lower urinary tract symptoms in Saudi Arabia: a single-centre experience

J Int Med Res. 2022 Aug;50(8):3000605221117221. doi: 10.1177/03000605221117221.

Abstract

Objective: To evaluate the effectiveness of sacral neuromodulation therapy (SNM) for lower urinary tract symptoms (LUTS) caused by neurological diseases.

Methods: This prospective cohort study enrolled patients that developed LUTS secondary to neurological disorders. All patients underwent staged SNM. A 5-day voiding diary was used to evaluate their response to the stage 1 procedure. Implantation of the full system during the stage 2 procedure was undertaken in patients that had ≥50% improvement on their voiding diary.

Results: Twenty-one patients were included in the study with the following neurological aetiologies: diabetes mellitus (n = 2), myelitis (n = 3), multiple sclerosis (n = 5), spinal cord injury (n = 10) and cerebrovascular accident (n = 1). Fifteen patients underwent the stage 1 procedure successfully; their mean age was 47.5 years and the mean follow-up was 29 months. SNM resulted in significantly increased voided volume/void/day, decreased leaking episodes/day, decreased postvoiding residual/day and decreased number of clean intermittent catheterization/day compared with baseline. Five patients were highly satisfied, nine were moderately satisfied and one patient was not satisfied with the therapy.

Conclusion: SNM was an effective therapy for LUTS caused by neurological disease and there was a high rate of patient satisfaction.

Keywords: Sacral neuromodulation; neurogenic bladder; neurogenic lower urinary tract symptoms; neurological disease.

MeSH terms

  • Electric Stimulation Therapy* / methods
  • Humans
  • Lower Urinary Tract Symptoms* / etiology
  • Lower Urinary Tract Symptoms* / therapy
  • Middle Aged
  • Prospective Studies
  • Saudi Arabia
  • Spinal Cord Injuries* / complications
  • Treatment Outcome