Sacral neuromodulation (SNM) is an effective therapy for refractory overactive bladder, urgency incontinence, non-obstructive urinary incontinence and fecal incontinence. Since 1999, the Interstim system has evolved from the original Interstim to InterstimII and now to InterstimX. The purpose of this study is to investigate device performance and surgical outcomes in patients who have undergone revisions from early versions of Interstim to InterstimX.

A retrospective chart review was conducted by identifying patients who underwent implantation of Interstim X at a tertiary academic hospital between February 2024 and October 2025. Patients who underwent a revision from an earlier device (REV) were compared to those undergoing their first InterstimX implant (INTX). Electronic medical records were reviewed. The primary outcomes of the study were success of implant at 3 month and presence of device programming difficulty.

A total of 51 patients were identified. Indication for InterstimX implant was urgency urinary incontinence (27, 55%), overactive bladder (4, 8%), BPS/IC (11, 22%), nonobstructive urinary retention (5, 10%), fecal incontinence (2, 4%), and neurogenic bladder (2, 4%). Nineteen patients were undergoing revision to InterstimX.  Nineteen patients (100%) in the REV group were female compared twenty-nine (91%) patients in the INTX group, p=0.29. The mean age was 63+/-13 in the REV group compared to 58+/-14 in the INTX group, p=0.23. There were no intraoperative complications recorded. There were no devices that needed removal in the REV group, but 6 (19%) required device removal in the INTX group, p=0.07. Success at 3 mos (n=46) was 89% in the REV group, compared to 71% in the INTX group (p=0.27). Success at 12 mos (n=43) was 78% in the REV group, compared to 64% in the INTX group, p=0.5. Device programming difficulty (n=43) occurred in 17% of the REV group, compared to 12% in the INTX group, p=0.68.

Patients undergoing revision from earlier InterStim devices to INTX demonstrate comparable success rates and low complication rates. Prior device experience did not compromise treatment effectiveness, and the low incidence of programming difficulties further supports the safety and usability of INTX.

Overall, patients undergoing revision to InterStimX demonstrate an excellent treatment response, with minimal difficulties programming the new device. InterstimX appears to be a safe and effective treatment modality for those with previous SNM devices. Further understanding into revision success and device performance is crucial to increase awareness among providers and guide future practice.