title: Sacral nerve stimulation and diurnal urine volume.
abstract: OBJECTIVE
  During a screening trial to determine candidacy for sacral nerve stimulation (SNS), several patients were required to repeat the baseline dietary because of discrepancies in the 24-hour urine output before and after successful stimulation. This raised a question regarding the relationship between urine production and neuromodulation. A more complete diary analysis of patients affected by urgency/frequency and/or urge incontinence was therefore carried out to evaluate the possibility of a direct modulatory influence of SNS on urine production.
  
  
  METHODS
  Voiding diaries of 40 patients (37 females and 3 males, average age 39.4 years) who underwent SNS were evaluated. Voiding diaries were obtained at baseline, during and after peripheral nerve evaluation (PNE) and after permanent implantation.
  
  
  RESULTS
  There was an increase in the average volume/void during PNE in 39 patients. Twenty-four-hour urine volume during PNE was statistically greater than that at baseline. Volume/void and diurnal volume were also significantly greater in follow-up periods after permanent implantation.
  
  
  CONCLUSIONS
  SNS appears to influence not only bladder function but also urine production. Increase in volume/void is paralleled by an increase in 24-hour urine output. The mechanism is unclear, but it is consistent with an altered release of antidiuretic hormone. This observation reflects the direct refractory involvement of the hypothalamus in micturition.
authors.affiliation: Neurourology Unit, Division of Urology, University of Colorado Health Sciences Center, Denver, Colo., USA.
authors.forename: M
authors.initials: M
authors.lastname: Ishigooka
authors.forename: D H
authors.initials: DH
authors.lastname: Zermann
authors.forename: R
authors.initials: R
authors.lastname: Doggweiler
authors.forename: R A
authors.initials: RA
authors.lastname: Schmidt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002940:Circadian Rhythm; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014555:Urination Disorders / Q000175:diagnosis / Q000628:therapy*; D014556:Urine / Q000502:physiology