Overactive bladder and urge urinary incontinence affect millions of women and men and results in billions of dollars in health care expenses. First- and second-line therapy includes behavioral modifications and/or pharmacotherapies however, many patients' symptoms remain or progress on these treatments. There has been concern regarding the detrimental side effects of the most widely prescribed medications for these bladder symptom management.Areas covered: As a result, there has been increased interest in continuous sacral neuromodulation, an FDA approved therapy for refractory urinary urgency and urge urinary incontinence. In this article, we specifically review current research on the efficacy and patient/ provider satisfaction and safety profile of the Axonics® System. In addition, we address the current state of sacral neuromodulation and potential future direction and applicability.Expert opinion: The Axonics® system is a safe effective device for the treatment of overactive bladder and urinary urge incontinence. Additionally, it affords patient's the convenience of a rechargeable, compact, MRI safe system. It should be noted that the rechargeable system, while allowing for approximately 15 years of battery and lead life, may have its challenges in terms of charge burden. Furthermore, this system is easily adapted for experienced implanters of sacral neuromodulating devices.
Article Highlights Third-line therapy for overactive bladder with sacral neuromodulation (SNM) has been associated with a 5-year therapeutic success rate of approximately 70% to 80%SNM systems continue to advance in technology allowing for miniaturized, rechargeable and MRI compatible devicesARTISAN-SNM study with two-year follow-up demonstrated 93% of participants were therapy responders and 82% had >75% reduction in episodes of urge incontinenceRELAX-OAB study demonstrated 79% of all subjects reported they would definitely or probably recommend SNM therefore this is an excellent therapy to recommend to patients with OABThe Axonics system provides a straightforward remote-controlled device with single program allowing for ease of patient use.
Expert review of medical devices. 2021 Jun 30 [Epub ahead of print]
Alice Wang, Elizabeth Rourke, Elisabeth Sebesta, Roger Dmochowski
Vanderbilt University Medical Center Nashville, TN, USA.