Objective This study aimed to assess urinary outcomes after sacral neuromodulation (SMN) implantation in patients with neurogenic bladder (NGB) and overactive bladder (OAB). Methods We conducted a retrospective chart review of patients who underwent permanent SNM implantation by a single surgeon between 2018 and 2025. Associated clinical encounters, operative reports, and patient-reported outcome measures were reviewed. Statistical analyses were performed using R (R Foundation for Statistical Computing, Vienna, Austria). Continuous variables were summarized using medians and interquartile ranges (IQR) and categorical variables using counts and percentages. Between-group comparisons were assessed using the Wilcoxon rank-sum test and chi-squared or Fisher's exact tests. Within-patient pre- and post-implant comparisons were analyzed using the Wilcoxon signed-rank test. Statistical significance was defined as p<0.05. Results One hundred and sixty-two patients who underwent permanent SNM implantation were included (NGB n=50; OAB n=112). The NGB group was younger (median age: 44.5 years; p<0.001) and had a slightly lower body mass index (BMI) (p=0.046). The OAB group was older (median age: 61.5 years) with BMI >30 and a varied sex distribution (p<0.001). Presenting symptoms differed between groups (p<0.001), with incomplete bladder emptying predominating among NGB patients and storage symptoms consistent with OAB predominating in the OAB cohort. Pre- and post-SNM comparisons indicated a decline in frequency, daytime void (p<0.001; r=0.76) and nighttime void (p<0.001; r=0.89), incontinence episodes (p<0.001; r=0.93), and daily pad usage (p<0.001; r=0.90). Despite differences in baseline characteristics and presentation, post-implant urinary outcomes were comparable in NGB patients and OAB patients (p=0.2435). Conclusion SNM implantation led to significant improvement in urinary symptoms in both groups. Post-implant urinary outcomes were comparable between groups despite differences in presentation. These findings suggest SNM effectiveness is better demonstrated by post-implant outcomes rather than by diagnostic category alone and support SNM as a therapeutic option across diverse bladder dysfunction etiologies.
Cureus. 2026 May 17*** epublish ***
Chelsae Nugent, Gabriel Carreño Galeano, Kellen Choi
Department of Urology, University of Louisville School of Medicine, Louisville, USA., Department of Urology, University of Louisville Hospital, Louisville, USA.