Sacral neuromodulation for multiple sclerosis patients with urinary retention and clean intermittent catheterization

Introduction and hypothesis

Multiple sclerosis is a chronic, debilitating, neurological disease with numerous urological manifestations including urinary detrusor overactivity, detrusor sphincter dyssynergia, and urinary retention. Can sacral neuromodulation be successfully implemented for urinary retention in ambulatory women with multiple sclerosis?

Methods

Between January 2002 and January 2008, we conducted an observational retrospective case–control study where 12 of 14 consecutive, ambulatory women with multiple sclerosis had stage 1/2 sacral neuromodulation performed under general anesthesia for urinary retention.

Results

Twelve of 14 patients (86%) were successfully implanted, with a mean follow-up of 4.32?±?1.32 years and mean postvoid residual of 50.5?±?21.18 ml. The mean maximum uroflow was 17.7?±?7.9 ml/s. Two of the 12 patients (17%) required revisional surgeries for lead migration, and 40% needed battery replacement.

Conclusion

Urinary retention in multiple sclerosis female patients can be successfully and safely managed with sacral neuromodulation with few complications with a mean of 4 years follow-up.