Chronic sacral neuromodulation in patients with lower urinary tract symptoms: Results from a national register

Purpose: The Italian Register was created in February 1997 to collect the n ational results of sacral neuromodulation. All Italian centers at which sac ral neuromodulation is performed were invited to participate in our study. We present the results from retrospective and prospective registers. Materials and Methods: A total of 196 patients underwent permanent implanta tion of sacral neuromodulation and were enrolled in the Italian register. T here were 18 males and 75 females in the retrospective, and 28 males and 75 females in the prospective studies. Student's t test was used to compare p aired values, and the Wilcoxon rank sum and nonparametric tests were used w hen necessary. Results: Mean incontinent episodes daily plus or minus standard deviation f or patients with detrusor instability went from 5.4 +/- 3.9 to 1.1 +/- 1.6 (median 5 and 0, respectively) at 12-month followup (p <0.001). For idiopat hic retention average residual volume decreased from 277 to 108 cc (median 287 and 80, respectively), and 50% of patients stopped catheterization and another 13% catheterized once daily at 1-year after implantation. With neur ogenic voiding disturbances, the results fluctuated with time from a minimu m of 33% to a maximum 66% of patients who did not catheterize at 6-month fo llowup and 12 months after implantation, respectively. At 12-month followup , 50% of patients with hyperreflexia had less than 1 incontinent episode da ily. The problem was completely solved in 66% of patients in the retention group. Of patients in the urge incontinent population 39% were completely d ry and 23% had less than 1 incontinent episode daily, Conclusions: Sacral neuromodulation is effective therapy for treating lower urinary tract symptoms resistant to less invasive therapy.