References

Amundsen CL, Komesu YM, Chermansky C Two-year outcomes of sacral neuromodulation versus onabotulinumtoxin A for refectory urgency urinary incontinence: a randomized trial. Eur Urol.. 2018; 74:(1)66-73 https://doi.org/10.1016/j.eururo.2018.02.011

Bartley J, Gilleran J, Peters K. Neuromodulation for overactive bladder. Nat Rev Urol.. 2013; 10:(9)513-521 https://doi.org/10.1038/nrurol.2013.143

Chen Y. Sacral nerve stimulation in patients with detrusor overactivity. Australian and New Zealand Continence Journal.. 2010; 16:(1)15-21

Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic drug exposure and the risk of dementia. JAMA Intern Med.. 2019; 179:(8)1084-1093 https://doi.org/10.1001/jamainternmed.2019.0677

Elneil S, Abtahi B, Helal M, Digesu A, Gonzales G. Optimizing the duration of assessment of stage-1 sacral neuromodulation in nonobstructive chronic urinary retention. Neuromodulation.. 2014; 17:(1)66-71 https://doi.org/10.1111/ner.12017

Elneil S. Urinary retention in women and sacral neuromodulation. Int Urogynecol J Pelvic Floor Dysfunct. 2010; 21:475-483 https://doi.org/10.1007/s00192-010-1277-z

European Association of Urology. Urinary incontinence guidelines. 2018. https://uroweb.org/guideline/urinary-incontinence/#1 (accessed 27 July 2020)

Fowler CJ, Kirby RS, Harrison MJ. Decelerating burst and complex repetitive discharges in the striated muscle of the urethral sphincter, associated with urinary retention in women. J Neurol Neurosurg Psychiatry.. 1985; 48:(10)1004-1009 https://doi.org/10.1136/jnnp.48.10.1004

Hashim H, Beusterien K, Bridges JFP, Amos K, Cardozo L. Patient preferences for treating refractory overactive bladder in the UK. Int Urol Nephrol.. 2015; 47:(10)1619-1627 https://doi.org/10.1007/s11255-015-1100-3

International Continence Society. Overactive bladder. 2018. https://tinyurl.com/y3b36vtt (accessed 27 July 2020)

Jones J, Van de Putte D, De Ridder D A joint mechanism of action for sacral neuromodulation for bladder and bowel dysfunction?. Urology. 2016; 97:13-19 https://doi.org/10.1016/j.urology.2016.05.032

Leong RK, de Wachter SGG, Joore MA, van Kerrebroeck PEV. Cost-effectiveness analysis of sacral neuromodulation and botulinum toxin A treatment for patients with idiopathic overactive bladder. BJU Int. 2011a; 108:(4)558-564 https://doi.org/10.1111/j.1464-410X.2010.09905.x

Leong RK, De Wachter SGG, Nieman FHM, de Bie RA, van Kerrebroeck PEV. PNE versus 1st stage tined lead procedure: a direct comparison to select the most sensitive test method to identify patients suitable for sacral neuromodulation therapy. Neurourol Urodyn. 2011b; 30:(7)1249-1252 https://doi.org/10.1002/nau.20979

Liberman D, Ehlert MJ, Siegel SW. Scaral neuromodulation in urological practice. Urology. 2017; 99:14-22 https://doi.org/10.1016/j.urology.2016.06.004

Marcelissen TAT, Leong RK, Nieman FHM, van Lankveld JJDM, van Kerrebroeck PEV, de Wachter SGG. Psychological and psychiatric factors as predictors for success in sacral neuromodulation treatment. BJU Int.. 2011; 108:(11)1834-1838 https://doi.org/10.1111/j.1464-410X.2011.10205.x

Mitchell PJ, Cattle K, Saravanathan S, Telford KJ, Kiff ES. Insertion under local anaesthetic of temporary electrodes for sacral nerve stimulation testing is reliable and cost effective. Colorectal Dis.. 2011; 13:(4)445-448 https://doi.org/10.1111/j.1463-1318.2010.02211.x

National Institute for Health and Care Excellence. Sacral nerve stimulation for idiopathic chronic non-obstructive urinary retention. Interventional procedures guidance IPG536. 2015. https://www.nice.org.uk/guidance/ipg536 (accessed 27 July 2020)

National Institute for Health and Care Excellence. Urinary incontinence and pelvic organ prolapse in women: management. NICE guideline NG123. 2019. https://www.nice.org.uk/guidance/ng123 (accessed 27 July 2020)

Olivera CK, Meriwether K, El-Nashar S Nonantimuscarinic treatment for overactive bladder: a systematic review. Am J Obstet Gynecol.. 2016; 215:(1)34-57 https://doi.org/10.1016/j.ajog.2016.01.156

Peters KM, Killinger KA, Boura JA. Is sensory testing during lead placement crucial for achieving positive outcomes after sacral neuromodulation?. Neurourol Urodyn.. 2011; 30:(8)1489-1492 https://doi.org/10.1002/nau.21122

Peeters K, Sahai A, De Ridder D, Van Der Aa F. Long-term follow-up of sacral neuromodulation for lower urinary tract dysfunction. BJU Int.. 2014; 113:(5)789-794 https://doi.org/10.1111/bju.12571

Prapasrivorakul S, Gorissen KJ, Gosselink MP. Temporary sacral neuromodulation under local anaesthesia using new anatomical reference points. Tech Coloproctol.. 2014; 18:(11)1093-1097 https://doi.org/10.1007/s10151-014-1207-z

Rice TC, Paquette IM. Technical considerations for sacral nerve stimulator insertion. Semin Colon Rectal Surg.. 2017; 28:(4)164-168 https://doi.org/10.1053/j.scrs.2017.07.004

Siegel S, Noblett K, Mangel J Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6-months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn.. 2015; 34:(3)224-230 https://doi.org/10.1002/nau.22544

Sukhu T, Kennelly M, Kurpad R. Sacral neuromodulation in overactive bladder: a review and current perspectives. Res Rep Urol. 2016; 8:193-199 https://doi.org/10.2147/RRU.S89544

Tanagho EA, Schmidt RA. Bladder pacemaker: scientific basis and clinical future. Urology.. 1982; 20:(6)614-619 https://doi.org/10.1016/0090-4295(82)90312-0

Tawadros C, Burnett K, Derbyshire LF, Tawadros T, Clarke NW, Betts CD. External urethral sphincter electromyography in asymptomatic women and the influence of the menstrual cycle. BJU Int.. 2015; 116:(3)423-431 https://doi.org/10.1111/bju.13042

Van Kerrebroeck PEV, Marcelissen TAT. Sacral neuromodulation for lower urinary tract dysfunction. World J Urol.. 2012; 30:(4)445-450 https://doi.org/10.1007/s00345-011-0780-2

An overview of sacral neuromodulation: a treatment for patients with symptoms of lower urinary tract dysfunction

13 August 2020
Volume 29 · Issue 15

Abstract

This article provides an introduction to patient selection for, and the processes involved in, sacral neuromodulation (SNM) device implantation as a treatment for urinary symptoms. SNM has been an option to treat lower urinary tract dysfunction for more than 20 years and is a treatment for both overactive bladder syndrome (OAB) and female non–obstructed chronic urinary retention (FCUR). It is recognised by the National Institute for Health and Care Excellence as a therapeutic option for OAB and FCUR. SNM has its place in the pathway for the treatment of both conditions and, in the correctly assessed patient, can be the last option before considering major surgical intervention.

Electrical stimulation of the sacral nerves as a treatment for the symptoms of lower urinary tract dysfunction (LUTD) dates back to the mid-1990s, when sacral nerve stimulation (SNS), an alternative term for sacral neuromodulation (SNM), received approval from the US Food and Drug Administration (Marcelissen et al, 2011).

The work of Tanagho and Schmidt (1982) first demonstrated the therapeutic potential of SNS in the early 1980s (Van Kerrebroeck and Marcelissen, 2012). During the past two decades, SNS has been adapted and refined, both in terms of the implantation techniques and the device electronics. SNM leads are now implanted percutaneously and some devices are both safe during magnetic resonance imaging (MRI) and rechargeable.

SNM can be used to treat two LUTD conditions: overactive bladder (OAB) syndrome and female non-obstructive chronic urinary retention (FCUR) (National Institute for Health and Care Excellence (NICE), 2015; Liberman et al, 2017; NICE, 2019).

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