Effect of sacral neuromodulation on bowel dysfunction in patients with neurogenic bladder

Abstract

Aim The aim of this retrospective study was to evaluate the clinical effect of sacral neuromodulation (SNM) on bowel dysfunction in patients with neurogenic bladder using the neurogenic bowel dysfunction (NBD) score. Method Between July 2012 and July 2019, 41 patients with both neurogenic bladder and bowel dysfunction underwent permanent SNM implantation. The NBD score was used to evaluate the bowel symptoms before the testing phase and at follow-up. The first follow-up was at the time of discharge after permanent implantation. The second follow-up was conducted by telephone after discharge. Results The mean NBD score before the testing phase was 11.0 AE 5.83, whilst it significantly decreased to 5.2 AE 5.32 (n = 41, P < 0.05) at the first follow-up (32 AE 3.9 days). Before the testing phase, there were 9 patients with very minor NBD, 10 with minor NBD, 13 with moderate NBD and 9 with severe NBD. At the first follow-up, there were 26 patients with very minor NBD, 7 with minor NBD, 4 with moderate NBD and 4 with severe NBD (P < 0.05). Twenty-six patients were interviewed in the long-term follow-up (34 AE 30.9 months). The NBD score in these 26 patients was 5.6 AE 5.18, which was not significantly different from the NBD score (5.5 AE 5.33) at the first follow-up (n = 26, P > 0.05). Conclusion SNM facilitates a significant reduction in NBD score in patients with neurogenic bladder and bowel dysfunction. The improvement in NBD symptoms can also be used as a future indicator to determine the clinical efficacy of permanent SNM implantation in the treatment of neurogenic bladder.