Sacral neuromodulation therapy of the lower urinary tract: A review of the literature and unanswered questions

Golnaz Alemi, Vani Dandolu

Department of Obstetrics and Gynecology, University of Nevada School of Medicine, Las Vegas, USA.

DOI: 10.4236/ojog.2013.34A001                

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.

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

Conflicts of Interest

The authors declare no conflicts of interest.

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