Clinical Efficacy Of Sacral Neuromodulation For Neurogenic Bladder: A Meta-analysis

Objective:To assess the efficacy and safety of sacral neuromodulation(SNM)for neurogenic bladder(NB).Methods:The studies were identified by electronic search of these databases of PubMed,EMBASE and Medline.The main outcomes were the incontinence episodes/24 h,frequency/24 h,bladder capacity,voiding volume,post-void residual volume before and after SNM therapy,the statistical analyses were performed using Review Manager 5.3(Cochrane Collaboration,Oxford,UK)software.Results:320 patients of 10 articles that met our inclusion criteria were included in this meta-analysis,including 2 prospective cohort studies and 8 retrospective case series.The improvements of main outcomes before and after SNM therapy are significant,incontinence episodes/24h(WMD-4.30;95%CI-5.65 to-2.94;p<0.00001),frequency/24h(WMD-5.21;95%CI-6.22 to-4.21;p<0.00001),bladder capacity(WMD91.74ml;95%CI 21.79 to 161.68;p=0.01),voiding volume(WMD 116.44ml;95%CI85.09 to 147.79;p<0.00001),post-void residual volume(WMD-339.97ml;95%CI-432.90 to 247.03;p<0.00001).Conclusion:This meta-analysis indicate that SNM may be effective and safe for treating NB,whether it is for urine retention symptoms or OAB symptoms.