Introduction: Sacral neuromodulation (SNM) is an effective third-line treatment, however, there is limited data involving male patients with overactive bladder (OAB) or non-bladder conditions (chronic pelvic pain and fecal incontinence [FI]). In this retrospective study, we followed 17 male patients with non-bladder conditions to assess efficacy, personal satisfaction, need for other treatments, and complications.

Methods: Between 2014 and 2021, 17 patients underwent SNM for pelvic pain and FI. All patients were followed from 1–7 years after SNM insertion.

Results: A total of 71% of the pelvic pain subgroup (n=7) had medication or pelvic physiotherapy treatment before SNM. After surgery, two patients had insufficient pain control (29%). SNM was largely well-tolerated, with a 71% satisfaction rate. Unfortunately, after one year of treatment, only 29% of the patients were satisfied and felt the improvement was significant. The need for other interventions was 71% and most of them were pelvic pain medication or BPH surgery. Complication rates were low (29%), including two patients with battery and lead pain (15%) and poor efficacy (14%). In the FI subgroup (n=10), four patients (40%) had previous surgeries (low anterior resection) and six had idiopathic FI. Following SNM implantation, only two patients had failure (20%). SNM resulted in high satisfaction within a year (90%) and beyond a year (80%). Complication rates were low (20%), including battery site pain (10%) and poor efficacy (10%). No FI patients required further treatments.

Conclusions: SNM in men with pelvic pain and FI is a useful and safe procedure. Most FI subgroup male patients were satisfied and improvement continue for years. The pelvic pain subgroup was mostly satisfied and improved within the first year, but this improvement diminished beyond a year and most required adjunct treatment. Finally, the success rate for FI in male patients is high, but mixed for pelvic pain patients; however, SNM may be useful in a multimodal treatment strategy.