Sacral Neuromodulation for Lower Urinary Tract Symptoms: Effect of Therapy on Saudi Patient Sexual Function

Abstract

Background Sacral neuromodulation (SNM) is FDA-approved therapy for lower urinary tract and bowel dysfunction. It is newly introduced therapy in Saudi Arabia. Aim To evaluate the effect of SNM therapy in both male and female Saudi patient s sexual function. Methods A prospective cohort study was conducted for all patients who underwent SNM implantation from January 2016 till January 2020 at a single center in Jeddah, Saudi Arabia. Sexual function was assessed before and after treatment using International Index of Erectile Function (IIEF-5) for men and the Female Sexual Function Index (FSFI) for women. Main Outcome measures Sexual function score changes from the baseline was reported. Correlation analysis was studied between IIEF-5 to assess erectile dysfunction and FSFI assessing desire, arousal, orgasm, pain and sexual satisfaction and other collected data including patient s age, functional diagnosis and post void residual (PVR). Results The study included 13 total patients (8 female, 5 male) with mean age 47y (33-60). Diagnosis included non-obstructive urine retention (5), refractory overactive bladder (3), combined retention + over active bladder (OAB) (1), pelvic pain syndrome (3) and impotence in 1 patient. All male patients showed significant improvement in their IIEF-5 score from mean pre op 7.8 ±5.7 to post op sore of 19.8±2.3 with significant p value p=0.003. Female patients showed significant improvement in their FSFI total score from baseline of 18.313±7.4 to post-operative mean FSFI score 26.7±1.8 with p value = 0.013. Domains od FSFI which showed significant improvement were desire, arousal, orgasm and sexual satisfaction with p value =0.002, p=00.1,0.012, and p=0.015. Age, functional diagnosis and PVR did not show significant correlation with IIEF-5 and FSFI score. Conclusion Our results suggest that SNM might improve male and female sexual dysfunction regardless of patient s age and diagnosis. Banakhar MA, Younos A. Sacral neuromodulation for lower urinary tract symptoms: effect of therapy on Saudi patient sexual function. Sex Med 2021;9:100388.