Sacral Neuromodulation Outcomes for Managing Urinary Incontinence in Patients With Overactive and Neurogenic Bladder

Objective This study aimed to assess urinary outcomes after sacral neuromodulation (SMN) implantation in patients with neurogenic bladder (NGB) and overactive bladder (OAB). Methods We conducted a retrospective chart review of patients who underwent permanent SNM implantation by a single surgeon between 2018 and 2025. Associated clinical encounters, operative reports, and patient-reported outcome measures were reviewed. Statistical analyses were performed using R (R Foundation for Statistical Computing, Vienna, Austria). Continuous variables were summarized using medians and interquartile ranges (IQR) and categorical variables using counts and percentages. Between-group comparisons were assessed using the Wilcoxon rank-sum test and chi-squared or Fisher's exact tests. Within-patient pre- and post-implant comparisons were analyzed using the Wilcoxon signed-rank test. Statistical significance was defined as p<0.05. Results One hundred and sixty-two patients who underwent permanent SNM implantation were included (NGB n=50; OAB n=112). The NGB group was younger (median age: 44.5 years; p<0.001) and had a slightly lower body mass index (BMI) (p=0.046). The OAB group was older (median age: 61.5 years) with BMI >30 and a varied sex distribution (p<0.001). Presenting symptoms differed between groups (p<0.001), with incomplete bladder emptying predominating among NGB patients and storage symptoms consistent with OAB predominating in the OAB cohort. Pre- and post-SNM comparisons indicated a decline in frequency, daytime void (p<0.001; r=0.76) and nighttime void (p<0.001; r=0.89), incontinence episodes (p<0.001; r=0.93), and daily pad usage (p<0.001; r=0.90). Despite differences in baseline characteristics and presentation, post-implant urinary outcomes were comparable in NGB patients and OAB patients (p=0.2435). Conclusion SNM implantation led to significant improvement in urinary symptoms in both groups. Post-implant urinary outcomes were comparable between groups despite differences in presentation. These findings suggest SNM effectiveness is better demonstrated by post-implant outcomes rather than by diagnostic category alone and support SNM as a therapeutic option across diverse bladder dysfunction etiologies.