[Implantable and programmable sacral neuromodulator (InterstimĀ®) treatment of urinary, fecal and combined incontinence]

Pichon Riviere A, Augustovski F, Garcia Marti S, Glujovsky D, Alcaraz A, Lopez A, Bardach A, Ciapponi A, Urtasun M
Record ID 32014000270
Authors' objectives: To evaluate the available evidence on the efficacy, safety and issues related with coverage policies for the use of implantable and programmable sacral neuromodulation (InterStimĀ®) in patients with urinary, fecal or combined incontinence.
Authors' recommendations: The evidence found is of poor methodological quality for all these indications. However, because the method is moderately invasive and relatively safe, the CPGs consulted consider SNM as a valid therapeutic alternative for patients with idiopathic UI who do not benefit from standard treatment. Its use for neurogenic UI cases is more controversial. For FI, the only guideline found recommends SNM in patients refractory to standard treatment, except for cases of complete spinal cord rupture. No specific indications for CI were identified. In patients <16 years old SNM is considered experimental. Coverage policies consider SNM as a therapeutic alternative in patients with UI or FI refractory to standard therapy. Some exclude FI coverage secondary to complete spinal cord rupture. There is no consensus for the rest of the incontinences that result from neurological lesions. It is important to evaluate each case individually taking into account age, preferences, general health condition and patient expectations at the time SNM is indicated.
Project Status: Completed
Year Published: 2013
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Argentina
MeSH Terms
  • Electric Stimulation Therapy
  • Lumbosacral Plexus
  • Prostheses and Implants
  • Fecal Incontinence
  • Urinary Incontinence
Organisation Name: Institute for Clinical Effectiveness and Health Policy
Contact Address: Dr. Emilio Ravignani 2024, Buenos Aires - Argentina, C1414 CABA
Contact Name: info@iecs.org.ar
Contact Email: info@iecs.org.ar
Copyright: Institute for Clinical Effectiveness and Health Policy (IECS)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.