Introduction: Sacral neuromodulation (SNM) has been found to be effective for refractory overactive bladder (OAB) symptoms/detrusor overactivity (DO). However, there is a paucity of research regarding the effect of SNM on nocturia, which can be a difficult lower urinary tract symptom to treat.

Methods: A retrospective chart review of patients who had an SNM implanted for refractory DO at our institution between July 2016 and July 2021 was done. All patients underwent a temporary peripheral nerve evaluation (PNE) and completed both pre-test and test-phase bladder diaries. Long-term followup of nocturia after SNM implantation was gleaned from clinic letters and bladder diaries.

Results: During the five-year time frame, 111 patients with refractory DO underwent SNM implantation. The Medtronic InterStim^TM II was the most common neurostimulator used (89%, 99/111). Of all patients with DO, 95 reported nocturia. Analysis of those with nocturia found 81% (77/95) were female, mean age 53 years (range 19–83), and median nocturia frequency was three times (1–7). SNM resulted in a statistically significant decrease in nocturia episodes during the PNE phase, with 78% (73/93) reporting ≥50% improvement in nocturia (median nocturia=1; Z=-8.333, p<0.001). Long-term followup data after full SNM implantation was available for 82 patients with a median followup of 25.5 months (range 1–63). Improvement in nocturia of ≥50% was reported by 62% (50/82) at long-term followup.

Conclusions: In patients with refractory OAB/DO, SNM was found to significantly decrease nocturia. Prospective studies are needed to better assess the impact of SNM on nocturia in patients with and without DO.