Overactive bladder (OAB) and non-obstructive urinary retention (NOUR) can be treated with sacral neuromodulation (SNM). Following device implantation, regular follow-up is required, and the device can be programmed to optimize symptom control through various adjustments. While the effectiveness of SNM in OAB and NOUR has been established, evidence regarding the need for, and difference in, reprogramming in these indications is limited. Therefore, this study aimed to compare the number of programming visits between OAB and NOUR patients treated with SNM.

Retrospectively data from patients with OAB and NOUR treated with SNM between 2015 and 2022 were analyzed including sex, age, diagnosis, operation dates, follow-up visits and programming records. The primary outcome was the difference in number of programming visits. Comparisons were performed using the Mann-Whitney U and Chi-square test of independence, and Kaplan-Meier survival analysis was conducted.

A total of 144 patients were included, comprising 104 with OAB and 40 with NOUR. Mean follow-up was 6.41 years (SD 2.61) and did not differ between groups. OAB patients required significantly more reprogramming visits during the follow-up period than NOUR patients (mean 2.59 vs. 1.43 visits, p < 0.001). Kaplan–Meier analysis showed shorter reprogramming-free survival in the OAB group (median 13.0 vs. 23.0 months, p = 0.031). There was no difference between the two indications in the need for, or timing of, lead revision, system explantation, or IPG replacement.

The mean amount of reprogramming visits significantly differed between both groups (NOUR 1.43 vs. OAB 2.59). The need for reprogramming showed a significant association with urological indication and remained significant in the Kaplan-Meier analysis, indicating that patients in the OAB group required programming sooner during SNM treatment compared to the NOUR group. There was no difference between the two indications in the need for, or time to lead revision, system explantation, or IPG replacement. These results suggest that patients with OAB exhibit a less stable response to

Patients with OAB undergoing SNM require more frequent and earlier reprogramming than those with NOUR. Revision and explantation rates were similar. Prospective studies with standardized protocols are needed.