OBJECTIVES: To review the technique, indications, results and working mechanisms of sacral neuromodulation (SNM) for lower urinary tract dysfunction. METHODS: The available literature on SNM for lower urinary tract dysfunction was searched. Based on the information available in the literature and also based on personal experience, the urological indications, technique, mechanisms of action and results of SNM are presented and discussed. RESULTS: SNM for lower urinary tract dysfunction involves stimulation of the 3rd sacral nerve with an electrode implanted in the sacral foramen and connected to a pulse generator. The technique is accepted by the FDA since 1997. Currently, SNM for lower urinary tract dysfunction has been successfully used in about 26,000 patients with various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. The actual procedure of SNM consists of a minimal invasive technique and is effective in about 70% of the patients who have been implanted with a permanent system. Also, in pelvic pain, interesting results have been described. SNM modulates the micturition reflexes at different levels in the central nervous system. CONCLUSIONS: Sacral neuromodulation is a safe and effective therapy for various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. It should be the first choice after failure of maximal conservative therapy.
OBJECTIVES: To review the technique, indications, results and working mechanisms of sacral neuromodulation (SNM) for lower urinary tract dysfunction. METHODS: The available literature on SNM for lower urinary tract dysfunction was searched. Based on the information available in the literature and also based on personal experience, the urological indications, technique, mechanisms of action and results of SNM are presented and discussed. RESULTS: SNM for lower urinary tract dysfunction involves stimulation of the 3rd sacral nerve with an electrode implanted in the sacral foramen and connected to a pulse generator. The technique is accepted by the FDA since 1997. Currently, SNM for lower urinary tract dysfunction has been successfully used in about 26,000 patients with various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. The actual procedure of SNM consists of a minimal invasive technique and is effective in about 70% of the patients who have been implanted with a permanent system. Also, in pelvic pain, interesting results have been described. SNM modulates the micturition reflexes at different levels in the central nervous system. CONCLUSIONS: Sacral neuromodulation is a safe and effective therapy for various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. It should be the first choice after failure of maximal conservative therapy.
Authors: W A Scheepens; M M G J Jongen; F H M Nieman; R A de Bie; E H J Weil; P E V van Kerrebroeck Journal: Urology Date: 2002-10 Impact factor: 2.649
Authors: Karl-Dietrich Sievert; Bastian Amend; G Gakis; P Toomey; A Badke; H P Kaps; Arnulf Stenzl Journal: Ann Neurol Date: 2010-01 Impact factor: 10.422
Authors: L Lagares-Tena; L Millán-Paredes; L Lázaro-García; A Navarro-Luna; S Delgado-Rivilla; A Muñoz-Duyos Journal: Tech Coloproctol Date: 2018-01-16 Impact factor: 3.781
Authors: Paul A Lehur; Michael Sørensen; Thomas C Dudding; Charles H Knowles; Stefan de Wachter; Stefan Engelberg; Klaus E Matzel Journal: Neuromodulation Date: 2020-03-09