Sacral neuromodulation as treatment of non-neurological vesical emptying disorders

Goal. - The goal was to evaluate the results of sacral neuromodulation (SNM) in non-neurological vesical emptying disorders. Patients and methods. - From February 2010 to October 2017, 28 patients presenting voiding symptoms or a non-obstructive chronic urine retention without neurological cause have been operated for an SNM (test phase). The test was positive in case of decreased number of proper intermittent self-catheterization (SC) or post-voiding residual urine (PVR) of at least 50 %. A 100 % positive result meant the return to a spontaneous voiding without SC with a non-significative PVR (< 100 ml). Results.- The median follow-up was of 53.2 +/- 21.2 months. Twenty-four (85.7%) tests were positive, from which twenty-two (78.6%) were 100% positive. 16 (84.2%) out of 19 patients with SC had spontaneous voiding without PVR. The number of daily SC decreased from 4.6 +/- 1.5 to 0.4 +/- 1.2 in post-operative (P< 0.001). The PVR was of 287.1 +/- 170.4 ml vs. 30.4 +/- 48.6 ml in post-operative (P< 0.001). Fourteen patients (58.3%) underwent at least one chirurgical revision or a removal of material ; mainly for loss of efficiency, end of battery, electrode migration and pain on material. At the end of the follow-up, 70.8% of the responding patients had their device still efficient. Conclusion. - Results showed that SNM appears to be an efficient treatment of non-neurological emptying vesical troubles. Nevertheless, the re-operation rate was still significant. (C) 2021 Elsevier Masson SAS. All rights reserved.