Effectiveness and safety of sacral neuromodulation for neurogenic bladder

ABSTRACT

Background

The treatment of neurogenic bladder (NB) is a challenge because conventional therapy often fails. Sacral neuromodulation (SNM) is a minimally invasive technique and an unconventional treatment for neurogenic bladder. Its research is still in the exploratory stage. The research on its effectiveness and safety is not clear.

Objective

To assess the effectiveness and safety of sacral neuromodulation (SNM) for neurogenic bladder (NB).

Methods

By searching the PubMed databases and Cochrane Library databases, combined with the method of literature tracing, the clinical researches and works on neurogenic bladder and sacral neuromodulation therapy were collected. Two reviewers independently selected and extracted data, (1) determine whether the study meets the inclusion criteria and exclude the literature that meets the exclusion criteria. (2) Researchers’ screening results and data, if there are differences in the results, will be discussed to eliminate the differences. (3) Read the full text of the literature carefully to determine the final literature to be included. (4) The relevant data of 11 independent studies, a total of 291 patients, were systematically reviewed using review manager 5.3 software.

Results

This research included 11 independent studies with a total of 291 patients. The improvements of main outcomes before and after SNM therapy were significant: incontinence episodes /24 h (WMD −2.52; 95%CI-3.14-1.90; p <0.001), frequency/24 h (WMD-5.96; 95%CI −6.27，-5.66; p <0.001), voiding volume (WMD 116.09 mL; 95%CI 86.68，145.51; p <0.001), cystometric capacity (WMD 129.84 mL; 95%CI 100.53, 159.15; p <0.001), post-void residual volume (WMD-198.00 mL; 95%CI-264.60, −131.40; p <0.001), clean intermittent self-catheterization/24 h (WMD-2.48; 95%CI −2.96, −2.00; p <0.001).

Conclusion

This systematic review indicated that the sacral neuromodulation treatment for neurogenic bladder was effective and safe.

KEYWORDS:

• Sacral neuromodulation
• neurogenic bladder
• systematic review
• meta-analysis
• sacral nerve stimulation

Disclosure statement

All of the authors had no any personal, financial, commercial, or academic conflicts of interest separately.

Ethics approval and consent to participate

This study was conducted in accordance with the declaration of Helsinki.This study was conducted with approval from the Ethics Committee of Liangxiang Hospital of Beijing Fangshan District. Written informed consent was obtained from all participants.

Author contributions

(I) Conception and design: Wei ZG and Zhang Y

(II) Administrative support: Wei ZG

(III) Provision of study materials or patients: Hou JP

(IV) Collection and assembly of data: Wei ZG and Zhang Y

(V) Data analysis and interpretation:Wei ZG and Zhang Y

(VI) Manuscript writing: All authors

(VII) Final approval of manuscript: All authors

Availability of data and materials

All data generated or analyzed during this study are included in this article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.