Sacral neuromodulation: Results of a monocentric study of 93 patients

Introduction. - Sacral nerve stimulation (NMS) is a therapeutic alternative for the treatment of urinary functional disorders as diverse as overactive bladder (OAB), urinary retention or pelvic pain syndromes. With the increasing use of NMS, we must deal with the postoperative management of this therapy. Objective. - We report the results, postoperative adverse events and their management in our center. Patients. This is a retrospective single-center single-operator study of 93 patients who were tested for NMS between January 2005 and December 2013. Results. - Of the 93 patients, 78 had a definitive implantation of the device for OAB (n = 44), urinary retention (n = 11), pain, interstitial cystitis (n = 12), bladder hyperactivity and pain (n = 8) or dysuria (n = 3). The average follow-up was 38.86 months (2.06 to 88.3 +/- 28.9). Among patients with OAB, 75% had a clinical improvement greater than or equal to 50%, 11.3% were considered as cured. Among patients with urinary retention, 63.5% were improved. Painful patients were improved for 58.3% of them, 2 were considered as cured. We reported 3 early postoperative complications (2 local infections, 1 hematoma), and adverse events in 49 patients (multiple visits for parameter settings, revision of the device [n=38], explantation [n=14]). Conclusion. Our results confirm the long-term effectiveness of NMS for the treatment of refractory overactive bladder, urinary retention, chronic pelvic pain, vesico-uretral dyssynergies. Studies are still needed to improve the selection of ideal candidates, identify prognostic factors and reduce the rate of complications and revisions. (C) 2014 Elsevier Masson SAS. All rights reserved.