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Sacral neuromodulation: Therapy evolution.

Jannah H Thompson1, Suzette E Sutherland, Steven W Siegel

  • 1Metropolitan Urology, Cornerstone Medical Specialty, 6025 Lake Road, Suite 100, Woodbury, MN, USA.

Indian Journal of Urology : IJU : Journal of the Urological Society of India
|December 1, 2010
PubMed
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Sacral neuromodulation (SNM) technology has advanced, improving treatment for overactive bladder and urinary retention. These innovations enhance efficacy and patient comfort, expanding therapeutic options.

Area of Science:

  • Urology
  • Neuromodulation
  • Medical Technology

Background:

  • Sacral neuromodulation (SNM) is a standard treatment for refractory overactive bladder (OAB) and non-obstructive urinary retention (NOUR).
  • Technological evolution has significantly improved SNM delivery and patient outcomes.
  • Understanding of SNM's mechanism continues to expand.

Purpose of the Study:

  • To review the evolution of sacral neuromodulation technology.
  • To discuss advances in SNM devices and techniques.
  • To explore expanding indications for SNM therapy.

Main Methods:

  • Review of technological advancements including tined leads, fluoroscopic imaging, and smaller implantable pulse generators (IPGs).
  • Discussion of percutaneous nerve evaluation (PNE) techniques, including bilateral PNE.
Keywords:
Refractory overactiveneuromodulationnon-obstructive

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  • Exploration of current and potential future applications of SNM.

    • Main Results:

    • Tined leads improve outpatient lead placement and efficacy with minimal migration.
    • Fluoroscopic imaging enhances lead placement accuracy, promoting bilateral PNE.
    • Smaller IPGs improve cosmesis and patient comfort, reducing revision rates.
    • Bilateral PNE is feasible in an office setting, reducing trial costs.

    Conclusions:

    • Technological progress in SNM delivery broadens patient eligibility.
    • Advancements make SNM potentially suitable for patients beyond those with refractory symptoms.
    • Continued research is identifying new applications for SNM therapy.