Lower urinary tract and bowel disorders and multiple sclerosis: Role of sacral neuromodulation: A preliminary report

Objective. In the present study we wanted to determine whether sacral neuromodulation benefits patients with bladder and bowel symptoms caused by multiple sclerosis (MS). Methods. At our Institute, five patients with MS underwent unilateral implantation of a sacral neuromodulation system, InterStim (Medtronic Inc., Minneapolis, Minnesota, USA), between April 2001 and June 2002; the mean follow-up was 30.4 months (range 24-38). The following parameters were evaluated before and after implant of the neurostimulator device: number of daily voidings, number of incontinent episodes, residual urine, Wexner score, quality of life (QoL), and psychological impact. Results. There was an overall 81.4% decrease of urgency and frequency with a significant decrease in the number of upper urinary tract infections and fever; there was a slight improvement in bowel function; there was an overall 51.8% improvement in the QoL and a discernible improvement emotional well-being. Conclusions. Unilateral chronic sacral neuromodulation can be a valuable treatment for neurogenic bladder and bowel disorders associated with MS.