Patients’ Perspectives and Challenges with Sacral Neuromodulation Implantable Pulse Generator

INTRODUCTION: Sacral neuromodulation (SNM) is an established therapy for refractory bowel and lower urinary tract dysfunction. While its efficacy and patient satisfaction are well documented, little is known about the physical burden of the implant itself. This study aimed to evaluate patient perspectives on the implantable pulse generator (IPG) placed in the gluteal region. METHODS: We reviewed 100 consecutive patients who underwent SNM within the past 2 years at a tertiary care center. Data were collected during follow-up visits or phone interviews using a five-question survey based on common patient concerns. Responses were analyzed descriptively, with statistical testing performed using SPSS version 29. RESULTS: Eighty-two patients received SNM for overactive bladder, 16 for urinary retention, and two for fecal incontinence. Sixty-two percent reported awareness of the IPG, 18% reported sleep or movement limitations, and 36% reported activity-related discomfort. Eleven percent turned off the device for non-MRI reasons. Overweight or obese patients (BMI >25) were less likely to report disturbances compared with normal-weight patients. Male patients were more likely than female patients to deactivate their device (P = 0.014), while older patients were less likely to turn it off. DISCUSSION: Most patients tolerated SNM well, though lower BMI was associated with greater discomfort, consistent with prior reports of higher revision rates in leaner individuals. Sex- and age-related differences suggest variations in device use behaviors, possibly due to lifestyle, activity level, or technological engagement. CONCLUSION: SNM is generally well tolerated, but leaner, younger, and male patients may experience greater device-related burden, highlighting the need for tailored counseling and device optimization.