Sacral neuromodulation therapy of the lower urinary tract: A review of the literature and unanswered questions

Abstract

Objective: To review the evidence surrounding Sacral\rNeuromodulation therapy and delineate areas that will need more research. Methods:\rAn extensive search was performed on the available literature on SNM for\rlower urinary tract dysfunction. Based on the results of the search, the mechanisms\rof action, indications, technique, and patient characteristics of therapy\rfailures and success are presented and discussed. Results: SNM is accepted by\rthe FDA since 1997 for the treatment of lower urinary tract dysfunction. As\rit is a relatively new procedure, there are variations in the technique of lead\rplacement, generator choice, testing interval, patient selection, time to\rexplantation, and definitions of therapy failures and successes. Conclusions:\rSNM is a safe and therapeutic option for the treatment of urgencyfrequency\rsyndrome, urge incontinence, and idiopathic urinary retention. However, there\rare multiple unanswered questions that require extensive research.