Long-term Outcomes of Sacral Nerve Stimulation in Pelvic Floor Dysfunctions.

The aim of this study is to analyse the long-term outcomes of SNS at a reference centre in both idiopathic and neurogenic pelvic floor disorders.

Retrospective observational study analysing the records of 106 tested patients in our department from December 1999 to January 2017. Efficacy variables evaluated were Global Response Assessment (GRA) (range from 0 to 100%) and, according to clinical indication, other specific variables such International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), number of catheterizations or pads/day and numerical pain scale (NPS). Safety variables analysed were complications (pain, migration, infection), reinterventions and explants. The quality of life (QoL) and satisfaction with the procedure were evaluated through a telephone interview.

Clinical indications: overactive bladder (OAB) (n=36), urinary retention (UR) (n=37), bladder pain syndrome/interstitial cystitis (BPI/IC) (n=19), faecal incontinence (FI) (n=8), double incontinence (DI) (n=6). Implant rates: OAB 55.6%, UR 56.8%, BPS/IC 63.15%, FI 87.5% and DI 66.7%. Clinical and/or statistically significant improvements in all efficacy variables studied were observed. The loss of therapeutic effect at 75 months follow-up was 34%. Device-related pain appeared in 25 patients (39%), 20 resolved by reprogramming and 5 required device removal. An overall improvement in QoL and high levels of satisfaction with the procedure were observed. More than 90% of patients would recommend SNS to a friend or relative.

SNS is a minimally invasive procedure that offers a real alternative to patients with refractory pelvic floor dysfunctions. Its safety profile is very favourable and provides a long-lasting improvement in symptoms and QoL.

International neurourology journal. 2021 Jan 27 [Epub ahead of print]

David Hernández-Hernández, Bárbara Padilla Fernánd, Milagros Castro Romera, Stephany Hess Medler, David Castro-Díaz

Servicio de Urología, Hospital Universitario de Canarias, Tenerife, Spain., Servicio de Cirugía, Hospital Universitario de Canarias, Tenerife, Spain., Departamento de Psicología Clínica, Psicobiología y Metodología, Universidad de La Laguna, Tenerife, Spain.