Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital

• Main Authors: Marcelo Mass-Lindenbaum (Author), Diego Arévalo-Vega (Author), Isidora Aleuanlli (Author), Fernanda Santis-Moya (Author), Andrea Maluenda (Author), Eitan Dines (Author), Miriam Cohen-Vaizer (Author), Álvaro Saavedra (Author), Trinidad Raby (Author), Bernardita Blumel (Author), Rodrigo Cuevas (Author), Simone Pohlhammer (Author), Gabriela Alarcon (Author), Marco Arellano Albornoz (Author), Javier Pizarro-Berdichevsky (Author)
• Format: Book
• Published: Federação Brasileira das Sociedades de Ginecologia e Obstetrícia, 2024-05-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 0100-7203; 10.61622/rbgo/2024ao11
• Keywords: Sacral neuromodulation; Urinary bladder; overactive; Non-obstructive urinary retention; Fecal incontinence; Incontinence; Electric stimulation therapy; Gynecology and obstetrics; RG1-991
• Source: Revista Brasileira de Ginecologia e Obstetrícia, Vol 46 (2024)

Abstract Objective: To show the experience of a Latin American public hospital, with SNM in the management of either OAB, NOUR or FI, reporting feasibility, short to medium-term success rates, and complications. Methods: A retrospective cohort was conducted using data collected prospectively from patients with urogynecological conditions and referred from colorectal surgery and urology services between 2015 and 2022. Results: Advanced or basic trial phases were performed on 35 patients, 33 (94%) of which were successful and opted to move on Implantable Pulse Generator (GG) implantation. The average follow-up time after definitive implantation was 82 months (SD 59). Of the 33 patients undergoing, 27 (81%)reported an improvement of 50% or more in their symptoms at last follow-up. Moreover, 30 patients (90%) with a definitive implant reported subjective improvement, with an average PGI-I "much better" and 9 of them reporting to be "excellent" on PGI-I. Conclusion: SNM is a feasible and effective treatment for pelvic floor dysfunction. Its implementation requires highly trained groups and innovative leadership. At a nation-wide level, greater diffusion of this therapy among professionals is needed to achieve timely referral of patients who require it.