A Meta-Analysis on the Efficacy and Safety of Sacral Neuromodulation for Neurogenic Bladder or Bowel Dysfunction.

Background: The aim of this work was to evaluate the efficacy and safety of sacral neuromodulation (SNM) in the treatment of neurogenic bladder (NB) and neurogenic bowel dysfunction (NBD).

Materials And Methods: A systematic literature search was conducted using PubMed and Web of Science up to August 2024, focusing on studies related to SNM treatment for NB or NBD. After assessing the quality of the studies, data were extracted and analyzed using Review Manager 5.3 (Cochrane Collaboration, Oxford, UK).

Results: A total of 15 studies involving 573 patients were included. After SNM treatment, the patients showed significant improvements in key outcome measures, including voiding frequency per 24 hours (weighted mean difference [WMD] -4.08; 95% CI -6.80, -1.35; p = 0.003), single voiding volume (WMD 123.60; 95% CI 93.17, 154.03; p < 0.001), number of leakage episodes per 24 hours (WMD -4.27; 95% CI -5.79, -2.74; p < 0.001), number of nocturia (WMD -2.48; 95% CI -2.62, -2.35; p < 0.001), clean intermittent self-catheterization per 24 hours (WMD -2.35; 95% CI -2.98, -1.71; p < 0.001), bladder compliance (WMD 9.09; 95% CI 2.31, 15.87; p = 0.009), maximum detrusor pressure during storage phase (WMD -14.76; 95% CI -18.63, -10.88; p < 0.001), maximum urine flow rate (WMD 6.50; 95% CI 4.21, 8.80; p < 0.001), maximum bladder capacity (WMD 66.28; 95% CI 2.83, 129.73; p = 0.04), Wexner score (WMD -9.98; 95% CI -13.65, -6.31; p < 0.001), and NBD score (WMD -6.31; 95% CI -6.89, -5.73; p < 0.001).

Conclusion: These results indicated that SNM was effective and safe in treating NB or NBD.