Advancing women's health: innovative applications of sacral neuromodulation in pelvic floor dysfunctions

Female pelvic floor dysfunctions (PFDs), a global health issue, encompass a range of lower urinary tract and bowel dysfunctions, including urinary incontinence, urinary retention, fecal incontinence, constipation, pelvic pain, and sexual dysfunction. PFDs exhibit high prevalence rates and prolonged recovery periods, resulting in significant economic burdens for patients and healthcare systems. Recently, sacral neuromodulation (SNM) has emerged as a minimally invasive, safe, and effective neuromodulatory intervention, representing a significant advance in the management of refractory PFDs. This technology modulates the sacral nerve reflex pathways through an implanted electrode, enabling simultaneous improvement of multiple PFD symptoms. It is specifically indicated for conditions including overactive bladder, non-obstructive urinary retention, and fecal incontinence, with potential therapeutic benefits extending to chronic pelvic pain, sexual dysfunction, and neurogenic bladder. This paper systematically reviews the underlying mechanisms and technological advancements of SNM, providing a comprehensive analysis of its established applications (overactive bladder, non-obstructive urinary retention, fecal incontinence) and examining emerging uses in other PFD domains. Furthermore, incorporating technological innovations and long-term follow-up data, this paper explores the optimization of indications, safety protocols, and future research avenues for SNM, offering a comprehensive outlook on clinical practice and prospective developments.