Sacral nerves neurostimulation

Abstract

This chapter discusses the concept of neurostimulation of the sacral nerve roots in treating voiding dysfunction. This chapter discusses the concept of neurostimulation of the sacral nerve roots in treating voiding dysfunction. Voiding dysfunction could be divided into two categories according to the underlying cause: 1. Neurogenic voiding dysfunction usually occurs following damage to the central or peripheral innervation of the bladder. A typical example of neurogenic bladder occurs following a suprasacral spinal cord injury. The primary function of the sacral stimulation is to enhance bladder evacuation. 2. Non-neurogenic voiding dysfunction affects a larger group of patients who have no apparent lesion in bladder innervation. These patients present with voiding dysfunction very similar to those with neurological lesions. A typical example of non-neurogenic voiding dysfunction is encountered in urge-frequency syndromes, chronic unobstructed urinary retention and patients with refractory urge incontinence. These patients respond to sacral neuromodulation of the pelvic floor musculature. © 2006 Springer-Verlag London Limited.