Who is a Candidate for a Bladder Pacemaker? Overactive Bladder and Urinary Incontinence

Bladder pacemaker (Sacral Neuromodulation) therapy is a highly effective surgical option for patients who have lost bladder control and whose social lives have severely deteriorated. However, a pacemaker is not directly implanted in every patient with urinary incontinence. This guide addresses the questions of who is a candidate for a bladder pacemaker and which indications yield the highest success rates.

Suitable Candidates for a Bladder Pacemaker

According to international guidelines, the main patient groups eligible for bladder pacemaker therapy are:

• Overactive Bladder and Urge Incontinence: Patients who experience sudden urges to urinate and cannot reach the toilet in time, and whose symptoms persist despite using medication multiple times a day.
• Non-Obstructive Urinary Retention: Patients who cannot empty their bladder spontaneously and must constantly use a catheter, despite having no enlargement (such as prostate) or obstruction in the urinary tract, due to the bladder muscles' inability to contract.
• Refractory Interstitial Cystitis (Painful Bladder Syndrome): Patients whose symptoms of bladder pain and frequent urination cannot be controlled with other treatments.

Who is Not Eligible?

A bladder pacemaker is not effective in cases of "Stress Urinary Incontinence," which occurs during physical exertion such as coughing or sneezing. In these patients, vaginal sling surgeries (TOT/TVT) are preferred. Additionally, pregnant women and patients whose cognitive functions are not suitable for managing the pacemaker remote control are not candidates for this surgery.