The Impact of New Sacral Neuromodulation Technologies on the Quality of Life of Patients with Refractory Overactive Bladder: A Mini-Review
Article Sidebar
Main Article Content
Abstract
Overactive bladder (OAB) affects millions of patients worldwide and significantly impairs quality of life. For patients with refractory OAB who fail conservative and pharmacological therapies, sacral neuromodulation (SNM) has emerged as a highly effective minimally invasive treatment option. Recent technological advances, particularly the development of rechargeable SNM systems with extended longevity and miniaturized designs, have transformed the therapeutic landscape. This mini review examines the impact of new SNM technologies on patient quality of life, comparing traditional non-rechargeable devices with newer rechargeable systems, and evaluating clinical efficacy, safety profiles, and patient satisfaction outcomes. Evidence demonstrates that both traditional and novel SNM systems provide sustained improvements in OAB symptoms and quality of life, with success rates ranging from 67-90% at long-term follow-up. Rechargeable systems offer the advantage of extended device longevity (15+ years) and reduced need for replacement surgeries, though recent data suggest potentially higher revision rates related to charging difficulties. Quality of life improvements are consistently demonstrated across multiple validated instruments, with patients reporting significant reductions in symptom burden and enhanced satisfaction. This review synthesizes current evidence to assist clinicians in navigating the evolving SNM landscape and selecting the most appropriate technology for patients with refractory OAB.
Article Details
Copyright (c) 2026 Elafari MA, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Cameron AP, Chung DE, Dielubanza EJ, Enemchukwu E, Ginsberg DA, Helfand BT, et al. The AUA/SUFU guideline on the diagnosis and treatment of idiopathic overactive bladder. J Urol. 2024;212(1):11-20. Available from: https://doi.org/10.1097/JU.0000000000003985
Farag F, Sakalis VI, Arteaga SM, Sihra N, Karavitakis M, Arlandis S, et al. What are the short-term benefits and potential harms of therapeutic modalities for the management of overactive bladder syndrome in women? A review of evidence under the auspices of the European Association of Urology Female Non-Neurogenic Lower Urinary Tract Symptoms Guidelines Panel. Eur Urol. 2023;84(3):302-312. doi:10.1016/j.eururo.2023.05.014. Available from: https://doi.org/10.1016/j.eururo.2023.05.014
Fu J, Li Z, Pu J, Liu Y, Mao Q, Li C, et al. Advancing women's health: innovative applications of sacral neuromodulation in pelvic floor dysfunctions. Arch Gynecol Obstet. 2025. Available from: https://doi.org/10.1007/s00404-025-08182-5
McCrery R, Lane F, Benson K, Taylor C, Padron O, Blok B, et al. Treatment of urinary urgency incontinence using a rechargeable SNM system: 6-month results of the ARTISAN-SNM study. J Urol. 2020;203(1):185-192. Available from: https://doi.org/10.1097/ju.0000000000000458
Blok B, Van Kerrebroeck P, de Wachter S,Ruffion A, Van der Aa F, Jairam R, Perrouin-Verbe MA, et al. A prospective, multicenter study of a novel, miniaturized rechargeable sacral neuromodulation system: 12-month results from the RELAX-OAB study. Neurourol Urodyn. 2019;38(2):689-695. Available from: https://doi.org/10.1002/nau.23892
Kaaki B, Gupta D. Medium-term outcomes of sacral neuromodulation in patients with refractory overactive bladder: a retrospective single-institution study. PLoS One. 2020;15(7):e0235961. Available from: https://doi.org/10.1371/journal.pone.0235961
Siegel S, Noblett K, Mangel J, Bennett J, Griebling TL, Sutherland SE, et al. Five-year followup results of a prospective, multicenter study of patients with overactive bladder treated with sacral neuromodulation. J Urol. 2018;199(1):229-236. Available from: https://doi.org/10.1016/j.juro.2017.07.010
Siegel S, Noblett K, Mangel J,Griebling TL, Sutherland SE, Bird ET, et al. Three-year follow-up results of a prospective, multicenter study in overactive bladder subjects treated with sacral neuromodulation. Urology. 2016;94:57-63. Available from: https://doi.org/10.1016/j.urology.2016.04.024
Blok B, Van Kerrebroeck P, de Wachter S, Ruffion A, Van der Aa F, Perrouin-Verbe MA, ,et al. Two-year safety and efficacy outcomes for the treatment of overactive bladder using a long-lived rechargeable sacral neuromodulation system. Neurourol Urodyn. 2020;39(4):1108-1114. Available from: https://doi.org/10.1002/nau.24317
Meng L, Tian Z, Zhang Y, Wang J, Liao L, Chen G, Tian X, et al. Sacral neuromodulation for overactive bladder using the InterStim and BetterStim systems. Sci Rep. 2022;12(1):22299. Available from: https://doi.org/10.1038/s41598-022-26267-y
Cohen T, Huang Z, Aalami-Harandi A, Park J, Sbrollini K, Braun N, et al. Revision rates for rechargeable versus non-rechargeable sacral neuromodulation devices in the management of overactive bladder. Neurourol Urodyn. 2025. Available from: https://doi.org/10.1002/nau.70053
Jairam R, Drossaerts J, Vrijens D, Leue C, Van Kerrebroeck P, Van Koeveringe G, et al. Affective symptoms and quality of life in patients with voiding or storage dysfunction: results before and after sacral neuromodulation: a prospective follow-up study. Neurourol Urodyn. 2018;37(5):1801-1808. Available from: https://doi.org/10.1002/nau.23527
Amundsen CL, Richter HE, Menefee SA, Komesu YM, Arya LA, Gregory WT, et al. OnabotulinumtoxinA vs sacral neuromodulation on refractory urgency urinary incontinence in women: a randomized clinical trial. JAMA. 2016;316(13):1366-1374. Available from: https://doi.org/10.1001/jama.2016.14617
Lo CW, Wu MY, Yang SS, Jaw FS, Chang SJ. Comparing the efficacy of onabotulinumtoxinA, sacral neuromodulation, and peripheral tibial nerve stimulation as third-line treatment for the management of overactive bladder symptoms in adults: systematic review and network meta-analysis. Toxins (Basel). 2020;12(2):E128. Available from: https://doi.org/10.3390/toxins12020128
Tilborghs S, De Wachter S. Sacral neuromodulation for the treatment of overactive bladder: systematic review and future prospects. Expert Rev Med Devices. 2022;19(2):161-187. Available from: https://doi.org/10.1080/17434440.2022.2032655
Parodi S, Kendall HJ, Terrone C, Heesakkers JPFA. What is in the pipeline on investigational neuromodulation techniques for lower urinary tract dysfunction: a narrative review. Neuromodulation. 2024;27(2):267-272. . Available from: https://doi.org/10.1016/j.neurom.2023.09.002
Amundsen CL, Sutherland SE, Kielb SJ, Dmochowski RR. Sacral and implantable tibial neuromodulation for the management of overactive bladder: a systematic review and meta-analysis. Adv Ther. 2025;42(1):10-35. Available from: https://doi.org/10.1007/s12325-024-03019-0