title: Sacral neuromodulation for lower urinary tract dysfunction.
abstract: OBJECTIVE
  To review the technique, indications, results and working mechanisms of sacral neuromodulation (SNM) for lower urinary tract dysfunction.
  
  
  METHODS
  The available literature on SNM for lower urinary tract dysfunction was searched. Based on the information available in the literature and also based on personal experience, the urological indications, technique, mechanisms of action and results of SNM are presented and discussed.
  
  
  RESULTS
  SNM for lower urinary tract dysfunction involves stimulation of the 3rd sacral nerve with an electrode implanted in the sacral foramen and connected to a pulse generator. The technique is accepted by the FDA since 1997. Currently, SNM for lower urinary tract dysfunction has been successfully used in about 26,000 patients with various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. The actual procedure of SNM consists of a minimal invasive technique and is effective in about 70% of the patients who have been implanted with a permanent system. Also, in pelvic pain, interesting results have been described. SNM modulates the micturition reflexes at different levels in the central nervous system.
  
  
  CONCLUSIONS
  Sacral neuromodulation is a safe and effective therapy for various forms of lower urinary tract dysfunction, including urgency, frequency and urgency incontinence as well as non-obstructive urinary retention. It should be the first choice after failure of maximal conservative therapy.
authors: Department of Urology, Maastricht University Medical Center, Maastricht, The Netherlands. p.vankerrebroeck@mumc.nl
authors: Philip E V
authors: PE
authors: Van Kerrebroeck
authors: Tom A T
authors: TA
authors: Marcelissen
mesh_terms: D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D059411:Lower Urinary Tract Symptoms / Q000628:therapy*; D008160:Lumbosacral Plexus / Q000502:physiology; D012447:Sacrum / Q000294:innervation*; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000628:therapy; D016055:Urinary Retention / Q000628:therapy; D014570:Urologic Diseases / Q000628:therapy*