Contrasting the percutaneous nerve evaluation versus staged implantation in sacral neuromodulation.
Sacral neuromodulation is increasingly used for the treatment of voiding dysfunction, pelvic pain syndromes, and gastrointestinal disorders. While increased use of this technology has led to a greater understanding of its potential as well as its limitations, difficulty persists in identifying the patients that will benefit most. Either of two trial stimulation techniques is performed before placement of a permanent neuromodulator: the monopolar percutaneous nerve evaluation and the tined quadripolar staged trial. The preponderance of recent literature asserts the superior sensitivity of the staged trial over percutaneous nerve evaluation. However, the techniques offer disparate advantages, and other issues, such as cost-effectiveness, remain largely unexplored. The role of sacral neuromodulation will continue to expand as physicians and patients become increasingly aware of its therapeutic potential. Widespread adoption of this clinically superior technique will most rapidly help the greatest number of patients.
Pelvic Medicine and Reconstructive Surgery, Arthur Smith Institute for Urology, North Shore - Long Island Jewish Healthcare System, 450 Lakeville Road, Suite M41, New Hyde Park, NY 11040, USA.
Chad
C
Baxter
Ja-Hong
JH
Kim
D002908:Chronic Disease; D003362:Cost-Benefit Analysis; D018856:Cystitis, Interstitial / Q000191:economics / Q000628:therapy; D005260:Female; D006801:Humans; D017699:Pelvic Pain / Q000191:economics / Q000628:therapy*; D012445:Sacrococcygeal Region; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D014555:Urination Disorders / Q000628:therapy*; D013519:Urogenital Surgical Procedures / Q000295:instrumentation / Q000379:methods*