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Updated: Jun 7, 2026
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Assessment of Neuromuscular Function Using Percutaneous Electrical Nerve Stimulation
Published on: September 13, 2015
A new minimally invasive technique for pudendal nerve stimulation
A T George1, T C Dudding, R J Nicholls
1Departments of Physiology Colorectal Surgery, St Mark's Hospital, North West London Hospitals NHS Trust, Harrow, UK.
Summary
A new finger-guided technique simplifies pudendal nerve stimulation (PNS) electrode placement by using the ischial spine as a landmark. This method ensures accurate lead positioning for treating bowel dysfunction without needing neurophysiological confirmation.
Area of Science:
- Neurology
- Surgical Techniques
- Gastroenterology
Background:
- Pudendal nerve stimulation (PNS) is an alternative to sacral nerve stimulation for certain conditions.
- Accurate electrode placement is crucial for effective PNS and typically requires neurophysiological confirmation.
- Existing techniques for PNS electrode insertion can be challenging.
Purpose of the Study:
- To describe and evaluate a novel, simplified method for pudendal nerve stimulation electrode insertion.
- To assess the accuracy and reproducibility of a finger-guided technique for electrode placement using the ischial spine.
- To determine if neurophysiological confirmation is necessary with this modified approach.
Main Methods:
- Cadaveric dissections were performed to validate surface markings for ischial spine guidance.
- A finger introduced per anum guided electrode insertion towards the ischial spine.
- Successful stimulation was confirmed by observed/palpated anal musculature contraction.
- Permanent electrodes were inserted, with position verified radiologically.
Main Results:
- Cadaveric studies confirmed accurate surface markings for needle insertion.
- The technique was successfully applied in 20 patients with bowel dysfunction.
- A low rate of lead displacement (1 instance) was observed over a 12-month follow-up.
Conclusions:
- Finger-guided assistance simplifies pudendal nerve stimulation electrode insertion.
- The technique is simple, reproducible, and accurate.
- Neurophysiological confirmation is not required to ensure correct lead location with this method.
