Editorial Comment: Systematic Literature Review and Meta-Analysis of Sacral Neuromodulation (SNM) in Patients with Neurogenic Lower Urinary Tract Dysfunction (nLUTD): Over 20 Years’ Experience and Future Directions

Abstract

Sacral neuromodulation (SNM) is an established third-line treatment for idiopathic lower urinary tract dysfunctions (LUTD) in patients who failed conservative therapies, such as behavioral and pharmacologicalstrategies (1). Most studies on SNM focused on the role of this minimally invasive treatment in patients presenting idiopathic overactive bladder (iOAB), chronic non-obstructive urinary retention and chronic pelvic pain. However, there is increasing evidence supporting the use of SNM for patients with adult neurogenic lower urinary tract dysfunction (ANLUTD). According to the International Continence Society (ICS), neurogenic overactive bladder (nOAB) is characterized by ‘urgency, with or without urgency urinary incontinence, usually with increased daytime frequency and nocturia in the setting of a clinically relevant neurologic disorder with at least partially preserved sensation (2). Neurogenic OAB is a common presentation of several neurologicdiseases, including CNS lesions (stroke, Parkinson’s disease, tumors, etc.) and spinal cord lesions. Studies on SNM for patients with neurological diseases tend to follow the same criteria used for patients with idiopathic LUTD (3)