Sacral Nerve Stimulation and Chronic Bladder Pain: Meta-Analysis.
Rodwan Husein, Moein Tavakkoli, Sara Ahmadi Abhari et al.
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In 30 seconds
This systematic review and random-effects meta-analysis assessed sacral nerve stimulation (SNS) for pain, urinary symptoms, and quality of life in adults with chronic bladder pain syndrome. Across 15 studies involving 494 patients, SNS was associated with a reduction in pain scores of -2.27 on a 0-10 scale (95% CI: -2.94 to -1.60, p < 0.001). Urinary frequency and nocturia also decreased, while changes in interstitial cystitis problem scores and quality of life were not statistically significant. The authors caution that methodological limitations constrain confidence in these findings.
Key findings
- Pain scores decreased by -2.27 on a 0-10 scale (95% CI: -2.94 to -1.60, p < 0.001).
- ICSI decreased by -2.18 (95% CI: -2.99 to -1.37, p < 0.001).
- Urinary frequency decreased by -1.71 voids/d (95% CI: -2.29 to -1.12), and nocturia by -1.49 episodes/night (95% CI: -2.35 to -0.63).
- ICPI and quality-of-life changes were not statistically significant; complication rates ranged from 0% to 40.6% and explantation rates from 0% to 18%.
Why it matters
The pooled findings suggest SNS may improve pain and some urinary symptoms in adults with chronic bladder pain syndrome, outcomes that can substantially affect daily functioning. However, the evidence does not establish treatment efficacy with the certainty of randomized comparisons, and reported complication and explantation rates varied. These results help frame potential benefit alongside uncertainty and procedural risks.
What to keep in mind
The authors report substantial methodological heterogeneity, moderate-to-high risk of bias, and no randomized controlled trials; these limitations restrict the strength of conclusions.