Sacral Neuromodulation in Elderly Patients

Urinary Urge Incontinence (UUI) is a common condition among women and increases its prevalence in relation to age.It is estimated that more than 200 million women worldwide live with this problem, which results in limitations in daily activities with impaired Quality of Life (QoL). Although the incidence and prevalence of UUI are higher in the elderly population, this condition should not be considered normal or unavoidable in the aging process of women. In fact, as reported by an epidemiological study carried out in the elderly community, the average cost per year of the UUI is 2.2-2.5 times greater than that of the general population. International guidelines recommend pharmacotherapy as a first option; unfortunately the elderly in many cases(40%) do not respond to the therapy or are not compatible with this approach for several reasons, including concomitant use of many other drugs, side effects, and, in this historical moment, even the economic aspect. Furthermore, about 20% of those who have an initial improvement with drug treatment suspend the therapy within 6 months due to the presence of side effects or lack of efficacy. In the literature there are few studies that evaluate minimally invasive proceduresfor UUI in elderly patients, and only one about the Sacral Neuromodulation System (SNS), which, however, did not evaluate the QoL.