Preliminary outcomes of sacral neuromodulation applications: Tertiary-center experience in Türkiye

Burcu Özalp; Mustafa Ozan Horsanalı; Meltem Uyar; Can Eyigör; Hüsnü Yılmaz; Adnan Şimşir

doi:10.19161/etd.1712538

TR EN

Sakral nöromodülasyon uygulamalarının ön sonuçları: Türkiye’de üçüncü basamak merkez deneyimi

Öz

Amaç: Sakral nöromodülasyon (SNM), çeşitli alt üriner sistem disfonksiyonları için minimal invaziv bir tedavi seçeneğidir. Yaygın kullanımına rağmen, etki mekanizması ve ideal hasta seçimi hâlâ tam olarak net değildir. Bu çalışma, Türkiye'deki üçüncü basamak sağlık merkezlerinde SNM uygulanan hastaların sonuçlarını raporlamayı amaçlamaktadır. Gereç ve Yöntem 2017–2022 yılları arasında üriner disfonksiyon, barsak disfonksiyonu veya kronik pelvik ağrı nedeniyle SNM uygulanan 16 hastanın retrospektif analizi yapıldı. Hastaların demografik özellikleri, tanıları, implantasyon süresi, komplikasyonlar ve semptom iyileşmeleri kaydedildi. Üriner fonksiyonlar, Uluslararası İnkontinans Danışma Anketi-Kısa Formu (ICIQ-SF) kullanılarak değerlendirildi. İstatistiksel analizler SPSS Statistics 26.0 programı ile gerçekleştirildi. Bulgular: Hastaların ortalama yaşı 42,4±11,9 yıl, ortalama vücut kitle indeksi 25,5±5,4 kg/m² idi. Semptom süresi ortalama 12,6±10,5 yıl, implantasyon yaşı ise 40,2±11,1 yıl olarak saptandı. SNM uygulamaları esas olarak idiyopatik mesane disfonksiyonu (%87,5) ve fekal inkontinans (%12,5) nedeniyle gerçekleştirildi. Ortalama ICIQ-SF semptom skoru, implantasyon öncesi 13,64±7,61 iken, implantasyon sonrası 7,50±7,51'ye düşerek anlamlı şekilde azaldı (p=0,003). Cerrahi müdahale gerektiren komplikasyonlar hastaların %12,5’inde gözlendi. Sonuç: Çalışmamız, SNM’nin üriner ve barsak disfonksiyonlarıyla ilişkili semptomları iyileştirmede etkili olduğunu göstermektedir; bu, ICIQ-SF skorlarındaki anlamlı düşüşle desteklenmektedir. Bununla birlikte, dikkat çekici düzeyde komplikasyon oranı, hasta seçiminin ve tedavi sürecinin dikkatli şekilde yönetilmesinin önemini ortaya koymaktadır. Farklı hasta gruplarında SNM'nin uzun vadeli etkinliğini ve güvenilirliğini değerlendirmek için daha geniş örneklem grupları ve daha uzun takip sürelerine sahip ileri çalışmalara ihtiyaç vardır.

Anahtar Kelimeler

Preliminary outcomes of sacral neuromodulation applications: Tertiary-center experience in Türkiye

Abstract

Aim: Sacral neuromodulation (SNM) is a minimally invasive treatment option for various lower urinary tract symptoms (LUTS) and bowel dysfunctions. Despite its widespread use, the exact mechanism of action and optimal patient selection remain unclear. This study aimed to report the outcomes of SNM in patients treated at tertiary health centers in Türkiye. Materials and Methods: A retrospective analysis was conducted on 16 patients who underwent SNM for LUTS, bowel dysfunction, or chronic pelvic pain between 2017 and 2022. Patient characteristics, primary diagnosis, implantation duration, complications, and symptom improvement were recorded. Urinary symptoms were assessed using the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Statistical analyses were performed using SPSS Statistics 26.0. Results: The mean age of the patients was 42.4 ± 11.9 years, with a mean BMI of 25.5 ± 5.4 kg/m². The mean duration of symptoms was 12.6 ± 10.5 years, and the mean age at implantation was 40.2 ± 11.1 years. SNM was primarily performed for idiopathic lower urinary tract dysfunction (87.5% of patients) and faecal incontinence (12.5%). The mean ICIQ-SF score significantly decreased from 13.64 ± 7.61 before implantation to 7.50 ± 7.51 after implantation (p = 0.003). A complication requiring surgical intervention occurred in 12.5% of patients. Conclusion: This study demonstrates that SNM is effective in improving symptoms associated with LUTS and bowel dysfunction, as evidenced by the significant reduction in ICIQ-SF scores. However, a notable complication rate was observed, highlighting the importance of appropriate patient selection and ongoing follow-up. Further studies with larger cohorts and longer follow-up are warranted to evaluate the long-term outcomes and safety profile of SNM.

Keywords

References

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Details

Primary Language

English

Subjects

Pain

Journal Section

Research Article

Authors

Burcu Özalp ^*
0000-0002-5023-9373
Türkiye

Mustafa Ozan Horsanalı
0000-0002-3651-0948
Türkiye

Meltem Uyar
0000-0001-8531-6351
Türkiye

Can Eyigör
0000-0002-7991-8564
Türkiye

Hüsnü Yılmaz
0000-0001-7889-9130
Türkiye

Adnan Şimşir
0000-0003-1519-5333
Türkiye

Publication Date

March 9, 2026

Submission Date

June 3, 2025

Acceptance Date

October 24, 2025

Published in Issue

Year 2026 Volume: 65 Number: 1

DOI

https://doi.org/10.19161/etd.1712538

IZ

https://izlik.org/JA67PF99DN

Cite

RIS / Bibtex

Vancouver

1.Burcu Özalp, Mustafa Ozan Horsanalı, Meltem Uyar, Can Eyigör, Hüsnü Yılmaz, Adnan Şimşir. Preliminary outcomes of sacral neuromodulation applications: Tertiary-center experience in Türkiye. EJM. 2026 Mar. 1;65(1):40-8. doi:10.19161/etd.1712538