Percutaneous sacral nerve root neuromodulation for intractable interstitial cystitis

Purpose: We evaluated the efficacy of percutaneous sacral nerve root neurom odulation in women with refractory interstitial cystitis. Material and Methods: We prospectively evaluated 15 consecutive women with a mean age of 62 years who had refractory interstitial cystitis to determin e the efficacy of percutaneous stimulation of the S3 sacral roots. The mean duration of symptoms before evaluation was 5.2 years. All women fulfilled the National Institute of Arthritis, Diabetes and Digestive and Kidney Dise ases criteria for the diagnosis of interstitial cystitis and were unrespons ive to standard oral or intravesical therapy. The response to treatment was assessed using pain scores, urinary diary variables and quality of life su rveys. Results: Mean voided volume during treatment increased from 90 to 143 mi. ( p <0.001). Mean daytime frequency and nocturia decreased from 20 to 11 and 6 to 2 times (p = 0.012 and 0.007, respectively). Mean bladder pain decreas ed from 8.9 to 2.4 points on a scale of 0 to 10 (p <0.001). As indicated by the Short Urinary Distress Inventory and SF-36 Health Survey, the quality of life parameters of social functioning, bodily pain and general health si gnificantly improved during the stimulation period. Of the women 73% reques ted to proceed to complete sacral nerve root implantation. Conclusion: Women with intractable interstitial cystitis respond favorably to percutaneous sacral stimulation with significant improvement in pelvic p ain, daytime frequency, nocturia, urgency and average voided volume. Perman ent sacral implantation may be an effective treatment modality in refractor y interstitial cystitis but further long-term evaluation is required.