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Related Concept Videos

The Micturition Reflex01:26

The Micturition Reflex

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Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
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The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
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Evolving types of pudendal neuromodulation for lower urinary tract dysfunction.

Stefano Parodi1,2, Harry J Kendall2, Carlo Terrone1

  • 1Department of Urology, IRCCS, Ospedale Policlinico San Martino, Genova, Italy.

Central European Journal of Urology
|April 22, 2024
PubMed
Summary

Pudendal neuromodulation (PNM) shows promise as a patient-friendly treatment for lower urinary tract dysfunction (LUTD) and overactive bladder. Further research is needed to integrate PNM into standard treatment algorithms.

Keywords:
lower urinary tract dysfunctionneuromodulationoveractive bladderposterior tibial nerve stimulationpudendal neuromodulationsacral neuromodulation

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Area of Science:

  • Urology
  • Neuromodulation
  • Pelvic Health

Background:

  • Existing treatments for lower urinary tract dysfunction (LUTD) and overactive bladder, such as sacral neuromodulation and posterior tibial nerve stimulation, offer reliable results.
  • There is an ongoing need for more patient-friendly therapeutic options in managing LUTD.
  • Pudendal neuromodulation (PNM) has emerged as a potentially valuable alternative treatment over the past few decades.

Purpose of the Study:

  • To review the current state of the art of pudendal neuromodulation (PNM).
  • To assess the efficacy and safety of various PNM techniques for LUTD.

Main Methods:

  • A comprehensive literature search was performed using Medline (PubMed) and Scopus (Elsevier).
  • A critical review of studies on PNM was conducted.
  • Various PNM approaches were examined, including percutaneous PNM, transrectal/transvaginal PNM, and dorsal genital nerve stimulation.

Main Results:

  • Different PNM techniques demonstrated promising improvements in various clinical outcomes.
  • Some studies reported superior results with PNM compared to sacral neuromodulation.
  • PNM techniques were found to be safe and effective in multiple studies.

Conclusions:

  • Pudendal neuromodulation (PNM) is a highly promising treatment for LUTD and overactive bladder, potentially expanding current therapeutic options.
  • PNM, in its various forms, offers a viable alternative for patients with LUTD.
  • Further research is essential to establish PNM's role in clinical treatment algorithms.