title: Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction.
abstract: METHODS
  This is a retrospective chart analysis.
  
  
  OBJECTIVE
  The objective of this study was to evaluate the effect of sacral neuromodulation (SNM) in patients with neurogenic lower urinary tract dysfunction (NLUTD).
  
  
  METHODS
  This study was conducted in a spinal cord injury rehabilitation center in Switzerland.
  
  
  METHODS
  The charts of all patients who underwent SNM (testing and/or permanent implantation) because of NLUTD at our institution between 2007 and 2013 were evaluated. Treatment outcomes and complications were recorded.
  
  
  RESULTS
  A total of 50 patients, 30 women and 20 men, with a mean age of 46 (±14) years, fulfilled the inclusion criteria. The most frequent cause for SNM was spinal cord injury in 35 patients (70%). Median duration of the underlying disease was 9.5 (±9.3) years. In all, 35 patients (70%) received a permanent implant. The complication rate was 16% (8/50). At the last follow-up, SNM was in use in 32 patients. In 26 patients with SNM because of detrusor overactivity, voiding frequency per 24 h was significantly reduced from 9 to 6, and daily pad use rate was significantly improved (2.6 versus 0.6 pads per 24h). On comparing urodynamic assessment of detrusor function before and under SNM, no significant suppression of neurogenic detrusor overactivity (NDO) was detected. In nine patients with chronic neurogenic urinary retention, median postvoid residual urine was significantly reduced from 370 to 59 ml. In all, 94% of the patients were either very satisfied or satisfied with SNM.
  
  
  CONCLUSIONS
  SNM might be an additional therapy option in carefully selected patients with NLUTD. On the basis of our results, urodynamic evaluation before SNM is mandatory, as the procedure does not seem to be suited to significantly alleviate NDO.
authors.affiliation: Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Wöllner
authors.affiliation: Clinical Trial Unit, Swiss Paraplegic Center, Nottwil, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Krebs
authors.affiliation: Neuro-Urology, Swiss Paraplegic Center, Nottwil, Switzerland.
authors.forename: J
authors.initials: J
authors.lastname: Pannek
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000175:diagnosis* / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012447:Sacrum / Q000294:innervation; D013127:Spinal Nerves; D016896:Treatment Outcome; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis* / Q000534:rehabilitation*