Guidance
The National Institute for Health and Clinical Excellence (NICE) issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on sacral nerve stimulation for urge incontinence and urgency-frequency.
It replaced the previous guidance on sacral nerve stimulation for urge incontinence (Interventional Procedures Guidance no. 4, August 2003) after the Interventional Procedures Advisory Committee reconsidered the procedure based on the results of a systematic review commissioned by NICE.
Further recommendations have been made as part of the clinical guideline on lower urinary tract symptoms published in May 2010, as follows:
- Consider offering implanted sacral nerve stimulation to manage detrusor overactivity only to men whose symptoms have not responded to conservative management and drug treatments.
Clinical and cost-effectiveness evidence was reviewed in the development of this guideline which has led to this more specific recommendation. More information is available from NICE guideline CG97. The IP guidance on sacral nerve stimulation for urge incontinence and urgency-frequency remains current, and should be read in conjunction with the clinical guideline.
Description
Sacral nerve stimulation is used in the management of severe urinary urge incontinence, a condition in which a strong urge to urinate is followed by an involuntary loss of urine.
Urge incontinence occurs more commonly in women and the elderly. The procedure involves placing electrodes and connecting them to an implantable pulse generator.
Coding and clinical classification codes for this guidance