Neuromodulation 10 years on: how widely should we use this technique in bladder dysfunction?

Abstract

Purpose of review: There has been growing interest in sacral nerve stimulation in the management of both overactivity syndromes and nonobstructive voiding dysfunction. Its increased use has led to a growth in experience with this treatment and where and when it is best used. At this point, some technical aspects of the use of neuromodulation have become more standardized and the next stages of research will hopefully shed light on how to maximize the efficacy of the technique.

Recent findings: Over the past year, there has been considerable interest and development of the use of neuromodulation in colorectal surgery and much of the literature has been in this field. Recent urological developments focus on modification of technique and attempts to identify which patients are more likely to find benefit.

Summary: Neuromodulation has a role in the treatment of nonobstructed urinary retention and overactive bladder syndrome, especially when accompanied by urgency incontinence. There are a number of unanswered questions remaining, however, which will need to be addressed to maximize its benefit.