Sacral nerve stimulation for the treatment of refractory voiding and bowel dysfunction.

Sacral nerve stimulation, sometimes referred to as a "pacemaker for the bladder and bowels" delivers nonpainful, electrical pulses to the sacral nerves to improve or restore function. A relatively simple procedure works via a complex mechanism to modulate the reflexes that influence the bladder, bowels, sphincters, and pelvic floor. Current approved indications include urinary urge incontinence, urgency-frequency, nonobstructive urinary retention, and fecal incontinence. The history, mechanism of action, evolution, and landmark literature for this treatment modality are reviewed.