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

Abstract

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.

Safety of Sacral Nerve Stimulation in Pregnancy: A Literature Review

“…This paper assessed different aspects of the quality of life of women on SNS treatment and their correlation to a number of suspected confounders such as age and pre‐treatment diagnosis. It demonstrated improvement in 5 quality of life aspects post‐implantation and with successful treatment, as well as an increase in the Female Sexual Function Index scores of the 23 assessed patients .…”

Prospective randomized study evaluating ultrasound versus fluoroscopy guided sacral InterStim® lead placement: A pilot study

“…Sacral neuromodulation with the InterStim device has been deemed an effective treatment modality in refractory urinary and bowel dysfunction . There have been many advances in the device since its inception.…”

“…The patient must show at least 50% improvement per objective measures in one or more bladder or bowel symptom categories. If satisfactory objective and subjective results are seen, then the patient can proceed to permanent InterStim implant …”

Affective symptoms and quality of life in patients with voiding or storage dysfunction: Results before and after sacral neuromodulation: A prospective follow‐up study

“…Previous studies showed an improvement in QoL, depression and OAB symptoms, however these studies included only patients with OAB. Furthermore, it has not been stated yet what impact successful treatment with SNM has on affective symptoms and quality of life …”