Sacral neuromodulation for the treatment of idiopathic non-obstructive urinary retention: A long-term follow-up case report.

BACKGROUND

Sacral neuromodulation (SNM) is a treatment used to manage urinary symptoms of both overactive bladder and non-obstructive urinary retention. The use of SNM in managing these symptoms has yielded positive results, contributing to a reduction in symptoms and an improvement in quality of life (QoL) for patients. This article aims to report on the electrical neurostimulation of sacral nerves to treat idiopathic non-obstructive urinary retention.

CASE DESCRIPTION: A 27-year-old female presented with chronic non-obstructive idiopathic urinary retention, using intermittent bladder catheterization, who did not respond to various treatments such as behavioral therapy, pelvic floor physiotherapy, and alpha-blockers. She underwent a sphincter injection of botulinum toxin type A. Due to the refractoriness of all previous treatments, electrical neurostimulation of the sacral nerves was proposed as an alternative. Two electrodes were implanted to stimulate the sacral nerves percutaneously in the foramina of S4 on both sides and connected to the neurostimulation system.

CONCLUSION

After the procedure, the patient experienced a reduction in the average voiding residue (47% immediately postoperative and 29% after 1 year), a significant decrease in urinary tract infections and bladder catheterizations (50% reduction), along with improvements in urinary symptoms, abdominal discomfort, and a substantial enhancement in QoL.