Introduction: Sacral neuromodulation (SNM) is an effective, guideline-supported, third-line treatment for overactive bladder (OAB). While the prevalence of OAB is similar between males and females, no studies assess the outcomes of SNM in male patients alone. In this retrospective study, we followed 53 male patients with neurogenic and idiopathic OAB to assess efficacy, personal satisfaction, complications, and need for other treatments.

Methods: Between 2014 and 2021, 53 male patients underwent SNM for neurogenic (n=7) and idiopathic (n=46) OAB. All patients were followed from 1–7 years after the SNM. Thorough chart review assessed patient satisfaction, symptom improvement, complications, and the need for other treatments.

Results: Most patients had medical therapy (79%) and/or intravesical Botox injection (28%) prior. After SNM, only five patients (9%) had insufficient symptom relief (<50% symptom improvement). Male patients reported high satisfaction within a year (91%), more than a year (81%), and significant improvement overall (94%). Most patients did not have any complications after surgery (77%) except for device pain (12%), insufficient efficacy (6%), and infection (5%). Most patients did not need other treatment after SNM (60%). Our analysis of the wet OAB subgroup (n=20) indicated the same early and long-term satisfaction (85%, 80%), overall improvement (90%), complication rate (<25%), and adjunct treatment percentage (35%) as compared to the entire OAB cohort. The neurogenic bladder subgroup (n=7) also experienced high satisfaction, both at less and beyond 12 months (100% and 86%, respectively), improvement in symptoms (100%), no complications, and 29% use of adjunct treatments.

Conclusions: SNM in men with neurogenic and idiopathic OAB is a useful and safe procedure. Most patients experience long-term satisfaction and improvements continue for years after the surgery. Finally, the complication rate in this study is less than the average found in the literature.