TITLE:
Sacral neuromodulation therapy of the lower urinary tract: A review of the literature and unanswered questions
AUTHORS:
Golnaz Alemi, Vani Dandolu
KEYWORDS:
Sacral Neuromodulation; SNM; Peripheral Nerve Evaluation; PNE; InterStim; Tined Lead Electrode; Implantable Pulse Generator; Lower Urinary Tract Dysfunction; Explantation; Urgency Frequency Syndrome; Urinary Retention; Incontinence
JOURNAL NAME:
Open Journal of Obstetrics and Gynecology,
Vol.3 No.4A,
June
13,
2013
ABSTRACT:
Objective: To review the evidence surrounding Sacral
Neuromodulation therapy and delineate areas that will need more research. Methods:
An extensive search was performed on the available literature on SNM for
lower urinary tract dysfunction. Based on the results of the search, the mechanisms
of action, indications, technique, and patient characteristics of therapy
failures and success are presented and discussed. Results: SNM is accepted by
the FDA since 1997 for the treatment of lower urinary tract dysfunction. As
it is a relatively new procedure, there are variations in the technique of lead
placement, generator choice, testing interval, patient selection, time to
explantation, and definitions of therapy failures and successes. Conclusions:
SNM is a safe and therapeutic option for the treatment of urgencyfrequency
syndrome, urge incontinence, and idiopathic urinary retention. However, there
are multiple unanswered questions that require extensive research.