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AUA: Overactive Bladder (2019)
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==== Sacral Neuromodulation ==== * <span style="color:#ff0000">'''May offer sacral neuromodulation (SNS) as third-line treatment in a carefully selected patient population characterized by severe refractory OAB symptoms or patients who are not candidates for second-line therapy and are willing to undergo a surgical procedure.'''</span> *'''<span style="color:#ff0000">Adverse events</span>''' *#'''<span style="color:#ff0000">Pain at the stimulator site</span>''' *#'''<span style="color:#ff0000">Pain at the lead site</span>''' *#'''<span style="color:#ff0000">Lead migration</span>''' *#'''<span style="color:#ff0000">Infection/irritation</span>''' *#'''<span style="color:#ff0000">Electric shock</span>''' *#'''<span style="color:#ff0000">Need for surgical revision</span>''' *#*In most studies, the need for surgical revision occurred in greater than 30% of patients. *#'''<span style="color:#ff0000">Difficulty passing through airport metal detectors</span>''' *#'''<span style="color:#ff0000">Inability to undergo magnetic resonance imaging (MRI)</span>''' *#<span style="color:#ff0000">'''Adverse events more frequent than PTNS'''</span> *#*There is some evidence that newer, less invasive surgical procedures and tined devices may be associated with fewer adverse events *Patients should be counseled that the device requires periodic replacement in a planned surgical procedure and that the length of time between replacements depends on device settings. Patients also must be willing to comply with the treatment protocol because treatment effects typically are only maintained as long as the therapy is maintained and have the cognitive capacity to use the remote control to optimize device function. *
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