Clinical Female Sexual Outcome after Sacral Neuromodulation Implant for Lower Urinary Tract Symptom (LUTS)

Lombardi, Giuseppe; Mondaini, Nicola; Macchiarella, Angelo; Cilotti, A; Popolo, Giulio Del

doi:10.1111/j.1743-6109.2008.00812.x

Cited by 57 publications

(45 citation statements)

References 26 publications

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“…43 Zahibi and colleagues used a different technique for SNM insertion and reported significant improvement in all domains and total FSFI score. 38 In contrast, Lombardi and colleagues saw significant improvements in satisfaction and total FSFI scores. 39 Our study showed improvement in 5 quality of life categories; this makes us question the indirect effect of SNM on sexual function.…”

Section: Discussionmentioning

confidence: 90%

“…[37][38][39][40][41] Although female sexual dysfunction is defined as FSFI ≤26, our study patients had low scores with mean FSFI baseline of 15 ± 9 and a mean post-SNM therapy FSFI of 18 ± 10, despite their statistically significance. In the literature, the cutoff point in the FSFI score to determine clinical improvement is undetermined; the FSFI is used as an assessment tool to detect any change post-therapy.…”

Section: Discussionmentioning

confidence: 94%

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Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

Banakhar

Gazwani²,

Kelini³

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e762-7. http://dx.doi.org/10.5489/cuaj.2300 Published online November 24, 2014. AbstractIntroduction: Sacral neuromodulation (SNM) has become an established therapy for voiding dysfunction. Additional benefits, such as improved bowel functions and bladder pain, have been reported. Improvement in female sexual function after SNM treatment has been suggested; however, reports examining the effects of SNM on female sexual functions are scarce. We evaluate the effects of SNM on female sexual function and its impact on quality of life and analyze any correlation. Methods: Data were collected from January 2010 to May 2012 for all female patients who underwent SNM InterStim (Medtronic, Minneapolis, MN) therapy at a single centre in Canada. They were treated for voiding dysfunction, including refractory overactive bladder, frequency-urgency syndrome and non-obstructive urinary retention. Patients were screened by percutaneous nerve evaluation (PNE) to assess their response to therapy using a 4-day voiding diary. Patients who experienced 50% or more improvement in their voiding parameters were permanently implanted. All patients completed the Female Sexual Function Index (FSFI), Short-Form Health Survey (SF-36), and incontinence questionnaires (Urinary Distress Inventory [UDI]-6) preoperatively and 4 months postoperatively. Results: A total of 33 female patients had SNM therapy; 10 were excluded from the study because they were not sexually active. The indications were: refractory overactive bladder in 19, frequencyurgency syndrome in 2, and non-obstructive urinary retention in another 2 patients. SNM therapy significantly improved the total FSFI score (p = 0.011); the components of desire and orgasm showed significant improvement (p = 0.014 and p = 0.035, respectively). Age, body mass index, diagnosis, and urinary symptoms did not show significant correlation with FSFI score improvement. Quality of life showed significant improvement after SNM treatment in 5 categories. There was no correlation between improvement in quality of life and FSFI. Conclusion: SNM may improve female sexual function and quality of life, yet there is no correlation between the improvement in FSFI and quality of life.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 94%

Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

Banakhar

Gazwani²,

Kelini³

et al. 2014

CUAJ

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“…More recently, literature documents the positive effects of SNM on sexuality in a heterogeneous group of female subjects, including spinal cord patients, when the method was used with the intent of improving neurogenic lower urinary tract symptoms (NLUTS). 4 However, information about SNM efficacy and adverse events in subjects with LUTS of neurogenic origin is sparse, and includes few individuals with a range of various neurological pathologies responsible for LUTS. Moreover, literature reports contrasting results in people with neurogenic bladder dysfunctions, even though the group consists of a restricted number of patients with a short follow-up.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of sacral neuromodulation in incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms

Lombardi

Popolo

2009

Spinal Cord

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Objective: To determine the efficacy and safety of sacral neuromodulation (SNM) in incomplete spinal cord injured (SCI) subjects affected by neurogenic lower urinary tract symptoms (NLUTS). Methods: Twenty-four SCI patients were enrolled. The individuals were divided into two groups: 13 individuals in the urinary retention category and 11 suffering from overactive bladder syndrome. All subjects underwent definitive SNM implantation (Medtronic, Inc.). Voiding symptoms were assessed using patient bladder diaries, which recorded both pre-SNM and before each follow-up (1, 3 and 6 months, and then every 6 months). Outcome measures were per 24 h: number of voids and voided volume per void for both groups; number of urinary leakages, pad use and nocturia for patients with overactive bladder syndrome; and volume per catheterization and number of catheterizations for urinary retention subjects only. Final checkups were completed by June 2008. Results: Median follow-up was 61 months. Up to the final visit, all subjects maintained a clinical improvement of more than 50% compared with baseline. Twenty-two side effects were recorded. Four subjects with urinary retention needed a new implant in the controlateral S3 sacral root because of loss of efficacy. One patient with urinary retention developed a wound infection at the implanted pulse generator site. Conclusions: Our study contains the largest series of implanted SCI patients ever published. SNM is a therapy to consider in the treatment of NLUTS for partial SCI patients, even if the loss of clinical benefits for patients with retentive NLUTS must be taken into account. All adverse events were treated effectively.

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“…In 2008 Lombardi et al [23] presented the results of their study on the effect of SNM on sexuality in 31 female patients. In this study both patients with idiopathic and with neurological causes for their LUTS were included.…”

Section: Discussionmentioning

confidence: 99%

Sexual Response in Patients Treated with Sacral Neuromodulation for Lower Urinary Tract Symptoms or Fecal Incontinence

Voskuilen¹,

Oerlemans²,

Gielen

et al. 2012

Urol Int

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Objectives: To determine whether sacral neuromodulation (SNM) for urinary symptoms or fecal incontinence gives improvement of female sexual function and whether improvement is due to physiological or psychological factors. Methods: Between 2002 and 2008, 8 patients had an array of questionnaires before and after SNM implantation. The questionnaires were: the Questionnaire for Screening for Sexual Dysfunctions, the Golombok Rust Inventory of Sexual Satisfaction, the Symptom Checklist-90, the Maudsley Marital Questionnaire and the McGill-Mah Orgasm Questionnaire. Three of these 8 patients underwent vaginal plethysmography before and after implantation. Results: No statistically significant changes were found, although there seems to be a trend toward improvement in orgasm scores. In plethysmography all 3 patients showed increased vaginal pulse amplitude with the stimulator turned on with both erotic and non-erotic stimuli. Conclusions: This study does not show a clear effect of SNM on sexual function, although there seems to be an improvement in orgasm scores. The lack of response on psychological questionnaires and the increase in vaginal pulse amplitude after SNM implantation indicate that there might be a physiological response.

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Clinical Female Sexual Outcome after Sacral Neuromodulation Implant for Lower Urinary Tract Symptom (LUTS)

Cited by 57 publications

References 26 publications

Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

Clinical outcome of sacral neuromodulation in incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms

Sexual Response in Patients Treated with Sacral Neuromodulation for Lower Urinary Tract Symptoms or Fecal Incontinence

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