Peripheral nerve evaluation (PNE) allows for a trial period for sacral neuromodulation to determine if the treatment is appropriate for a given patient. Typically, PNE rates of success have been lower than a staged implant approach which has led to concern for lead migration [1,2].  A new PNE wire was introduced in 2020, however, there is limited data assessing success rates after this change. We aimed to evaluate 10 years of data to assess at a single institution before and after the lead change.

A retrospective review of PNE patients at a large academic center from 2015 to 2025 was performed. Patients included those with urgency-frequency, urge urinary incontinence (UUI), or fecal incontinence (FI). Those with nonobstructive urinary retention were excluded. We assessed rates of PNE trial success, which was defined as equal to or greater than 50% improvement in symptoms by patient diary. We estimated a propensity score for receiving the old vs new lead using a logistic regression model including age, BMI, sex, smoking status, diabetes, stroke, other neurologic diagnoses, urgency-frequency or UUI, and FI. Outcomes were compared using the Rao-Scott adjusted chi-square tests and weighted logistic regression models with robust standard errors. With the available matched sample (n=89 vs 225), the study had ~80% power (α=0.05, two-sided) to detect an absolute difference of approximately 12%; and detecting a 10 percent difference would require roughly 142 vs 359 patients.

A total of 419 PNE procedures were included, and after matching there were 314 patients. Demographics were similar between groups, though there were slightly higher rates of sensation reported in the later group (91.0% vs 98.1%, p=0.005). Overall, 82% (256/314) of patients had a successful PNE trial. From 2015 to 2019, the success rate was 78.7% (70/89). From 2020 to 2025, the success rate was 82.7% (186/225, p=0.501), which was not statistically significantly different.

PNE is an effective option for sacral neuromodulation trial. Our institution has high rates of PNE trial success, which are comparable to a staged approach as published in the literature [3].

We did not find a statistically significant increase in PNE trial success after the introduction of the new lead, however success rates remained high and there was a slightly higher percentage of success in the later group.

Borawski KM, Foster RT, Webster GD, Amundsen CL. Predicting implantation with a neuromodulator using two different test stimulation techniques: a prospective randomized study in urge urinary incontinent women. Neurourol Urodyn. 2007;26(1):14-18.
Janknegt RA, Weil EH, Eerdmans PH. Improving neuromodulation technique for refractory voiding dysfunctions: two-stage implant. Urology. 1997;49(3):358-362.
Spinelli M, Weil E, Ostardo E, et al. New tined lead electrode in sacral neuromodulation: experience from a multicentre European study. World J Urol. 2005;23(3):225-229.

Continence 19S (2026) 102681
DOI: 10.1016/j.cont.2026.102681