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. 2013 Jun;32(5):476-9.
doi: 10.1002/nau.22319. Epub 2012 Nov 20.

Sacral neuromodulation effects on periurethral sensation and urethral sphincter activity

Jonathan L Gleason  1 , Kimberly Kenton, W Jerod Greer, Olga Ramm, Jeff M Szychowski, Tracey Wilson, Holly E Richter
Affiliations

Sacral neuromodulation effects on periurethral sensation and urethral sphincter activity

Jonathan L Gleason et al. Neurourol Urodyn. 2013 Jun.

Abstract

Aims: To characterize the effect of sacral neuromodulation (SNM) on urethral neuromuscular function.

Methods: Following IRB approval, women with refractory overactive bladder (OAB) underwent standardized urethral testing prior to and after Stage 1 SNM implantation. Periurethral sensation was measured using current perception thresholds (CPT). Striated urethral sphincter activity was quantified using concentric needle electromyography (CNE) and Multi-Motor Unit Action Potential (MUP) analysis software. Nonparametric analyses were used to characterize pre/post changes with intervention. Baseline CPT and CNE findings were compared between SNM responders and non-responders.

Results: Twenty-seven women were enrolled in this pilot study with a mean age of 61 ± 13 years. Twenty of 26 women (76.9%) responded to SNM and went to Stage 2 permanent implantation. Four (14.8%) withdrew after Stage 1 implantation; three of the four withdrawals had not had therapeutic responses to SNM. CPT and CNE parameters did not significantly differ from baseline 2 weeks after SNM. Pre-SNM urethral sensation was not significantly different between responders and non-responders. However, responders had larger amplitude, longer duration and more turns and phases at baseline approaching significance, reflecting more successful urethral reinnervation, than non-responders.

Conclusions: SNM does not alter urethral neuromuscular function 2 weeks post Stage 1 implantation.

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