Early Sacral Neuromodulation: A Promising Opportunity or an Overload for Patients with a Recent Spinal Cord Injury? A Cross-Sectional Study

J. Clin. Med., 2025 · DOI: https://doi.org/10.3390/jcm14031031 · Published: February 6, 2025

Simple Explanation

This study explores how patients with long-term spinal cord injuries feel about the possibility of having received early treatment, specifically sacral neuromodulation (SNM), to manage bladder issues that often arise after such injuries. The research found that a significant number of patients, looking back, would have been open to early intervention, even a minimally invasive procedure like SNM, before bladder problems became severe. The study emphasizes that good communication and education are essential for patients and caregivers to make informed decisions about early treatment options for bladder dysfunction following spinal cord injury.

Study Duration

Two years

Participants

86 patients with spinal cord injury

Evidence Level

Cross-sectional study

Key Findings

1
61.9% of patients stated they would have consented to early therapy prior to the emergence of their neurogenic lower urinary tract dysfunction.
2
Of those who would have consented to early therapy, 51.8% would have consented to early sacral neuromodulation.
3
More than half of the patients (57.0%) stated they had not grasped the momentous nature of neurogenic lower urinary tract dysfunction when being informed about it.

Research Summary

The study investigated patients’ attitudes toward early sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction (nLUTD) after spinal cord injury (SCI). Results showed that a significant percentage of patients would have agreed to early treatment, including SNM, before the onset of severe bladder dysfunction. The study highlights the importance of early and thorough patient education regarding the potential for nLUTD following SCI to improve quality of life.

Practical Implications

Improved Patient Counseling

Neuro-urologists should provide regular and extensive counseling to patients with SCI regarding potential bladder dysfunction.

Clinical Trial Expansion

Widespread clinical trials of early SNM should be offered to patients willing to try it, ensuring constructive dialogue between caregivers and patients.

Standard Operation Procedures

Implementation of standard operation procedures (SOPs) in clinical settings is needed to facilitate larger clinical trials to prove the efficacy of early SNM.

Study Limitations

1
The retrospective nature of the analysis may have introduced bias.
2
The patient population may not reflect the average population due to access to continued neuro-urological care.
3
The small number of patients in the sacral lesion group made comparisons statistically not feasible.

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