What is the purpose of a Sacral Neuromodulation (SNM) implant?

From the Guidelines

Sacral neuromodulation implants should be offered to patients with overactive bladder who have an inadequate response to, or have experienced intolerable side effects from, pharmacotherapy or behavioral therapy, as they have been associated with high success rates, durable efficacy, and excellent patient satisfaction. According to the 2024 AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder 1, sacral neuromodulation is a recommended treatment option for patients with OAB who have failed first-line therapies. The guideline states that clinicians should offer sacral neuromodulation, tibial nerve stimulation, and/or intradetrusor botulinum toxin injection to these patients, with a moderate recommendation and evidence level of Grade A.

Some key points to consider when recommending sacral neuromodulation implants include:

• High success rates, with studies showing effectiveness in reducing voiding frequency, nocturia, urgency episodes, and incontinence episodes 1
• Durable efficacy and excellent patient satisfaction, making it a viable option for long-term management of OAB
• Minimally invasive procedure, with a low risk of serious complications
• Potential for individualized treatment plans, taking into account patient preferences and values

The advantages of sacral neuromodulation implants include:

• Effective in reducing symptoms of OAB, including voiding frequency, nocturia, and incontinence episodes
• Minimally invasive procedure, with a low risk of serious complications
• Can be used in combination with other therapies, such as behavioral therapy and pharmacotherapy
• Offers a high degree of patient satisfaction and quality of life improvement

Overall, sacral neuromodulation implants are a valuable treatment option for patients with OAB who have failed first-line therapies, and should be considered as part of a comprehensive treatment plan.

From the Research

Sacral Neuromodality Implant

• A sacral neuromodality implant, also known as sacral nerve stimulation (SNS), is a treatment option for various bowel and urinary disorders 2, 3, 4, 5, 6.
• The implant involves the placement of a device that stimulates the sacral nerves, which can help to restore normal bowel and urinary function.

Indications for Sacral Neuromodality Implant

• The implant is commonly used to treat fecal incontinence, urinary incontinence, and chronic constipation 2, 4, 5.
• It is also used to treat neurogenic lower urinary tract dysfunction, which can occur in patients with spinal cord injuries 3.
• The implant may be considered for patients who have not responded to other treatments, such as medication or behavioral therapy.

Efficacy of Sacral Neuromodality Implant

• Studies have shown that the implant can be an effective treatment option for fecal incontinence, with significant improvements in symptoms and quality of life 2, 5.
• The implant has also been shown to be effective in treating urinary incontinence and chronic constipation 4.
• However, the efficacy of the implant can vary depending on the individual patient and the specific condition being treated.

Risks and Complications of Sacral Neuromodality Implant

• The implant is generally considered to be a safe and minimally invasive procedure, but there are some potential risks and complications, such as infection, bleeding, and device malfunction 6.
• The risk of device revision or explantation is higher in younger patients, with a median age of 50 years 6.
• However, the overall incidence of complications is relatively low, and the benefits of the implant can outweigh the risks for many patients.