Lehner, K

Abstract Introduction Sacral neuromodulation (SNM) is an effective third line treatment for overactive bladder (OAB). It is estimated that 10-27% of men suffer from OAB, however, prior studies on SNM have only reported on female-predominant cohorts. OAB in the male patient has gender-specific complexity given the effects of prostatic anatomy and associated therapeutics on voiding function, which may influence treatment outcomes and underutilization of SNM in this population. Objective We sought to assess a dedicated cohort of male patients undergoing SNM for refractory OAB by a single surgeon at our institution. Methods A retrospective cohort study was conducted, analyzing medical records of male patients who underwent SNM implantation for OAB by a single surgeon between February 2023 and September 2024. Data extraction encompassed demographic characteristics, urological history, and micturition parameters. The latter were assessed by using validated bladder diaries completed pre- and post-SNM implantation. Comparative analysis was conducted using independent t-tests and chi-square tests. Results Over the study period, 39 patients underwent either a peripheral nerve evaluation (PNE) or first stage SNM procedure, of which 32 (82.1%) had greater than 50% improvement in symptoms and underwent second stage implantation. 97.4% of the cohort had previously failed OAB medications, 25.6% had previously undergone bladder Botox, and 15.4% had previously undergone percutaneous tibial nerve stimulation. 30.8% had undergone a previous bladder outlet procedure (Table 1). In the cohort that underwent second stage implantation, average total voids in 24 hours improved from a median of 20.9 to 10.3 (Table 2, p<0.001), daily leakage episodes improved from 3.9 to 1.3 (p=0.001) and pad usage improved by >50%. Conclusions In this exploratory cohort, SNM demonstrated safety and efficacy in improving symptoms and quality of life for men with treatment-refractory OAB. Disclosure No