What is the efficacy of sacral neuromodulation in the treatment of interstitial cystitis/bladder pain syndrome (IC/BPS)?

Updated: Dec 04, 2020
  • Author: Eric S Rovner, MD; Chief Editor: Edward David Kim, MD, FACS  more...
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Answer

Studies in patients with interstitial cystitis refractory to conservative measures (ie, behavioral modification, diet, medications, hydrodistention) have found that sacral neuromodulation improved daytime frequency, nocturia, and mean voided volumes and decreased pain and interstitial cystitis symptom and problem index scores. In patients on long-term narcotics for refractory pain associated with interstitial cystitis, sacral neuromodulation has been shown to decrease (but not eliminate) narcotic requirements.

However, some authors have challenged these results. The frequency that arises in patients with IC/BPS is one in which patients void frequently to avoid pain with bladder filling. The studies showing benefit from sacral neuromodulation are all observational, small, single-center studies. Patients should be made aware that the indications for sacral neuromodulation are for voiding symptoms, and any effect on pain is unpredictable.


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