title: A Joint Mechanism of Action for Sacral Neuromodulation for Bladder and Bowel Dysfunction?
abstract: Sacral neuromodulation (SNM) is a clinically effective intervention for treatment of urinary and bowel disorders. The aim is to establish the hypothesis that there is a common mechanism of action for SNM in both systems. Current knowledge includes the following: (1) Therapeutic parameters may be different for the 2 efficacy measures. (2) SNM invokes neural circuits that can be observed as neurochemical changes in specific neuroanatomic structures downstream from the therapy delivery site. (3) There are important central nervous system effects for both therapies. (4) Clinical observations regarding normal continence sensations as well as physiological measures of continence are different for the 2 therapy areas.
authors.affiliation: School of Medicine and Medical Science, University College Dublin, Ireland.
authors.forename: James
authors.initials: J
authors.lastname: Jones
authors.affiliation: Department of Gastrointestinal Surgery, Ghent University Hospital, Ghent, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: Van de Putte
authors.affiliation: Department of Development and Regeneration, Urology Unit, Katholieke Universiteit Leuven, Leuven, Belgium.
authors.forename: Dirk
authors.initials: D
authors.lastname: De Ridder
authors.affiliation: National Centre for Bowel Research and Surgical Innovation, Barts and the London School of Medicine & Dentistry, Queen Mary University of London, London, UK.
authors.forename: Charles
authors.initials: C
authors.lastname: Knowles
authors.affiliation: School of Medicine and Medical Science, University College Dublin and Centre for Colorectal Disease, St Vincent's University Hospital, Dublin, Ireland.
authors.forename: Ronan
authors.initials: R
authors.lastname: O'Connell
authors.affiliation: Global Research, Neuromodulation, Medtronic PLC, Minneapolis, MN.
authors.forename: Dwight
authors.initials: D
authors.lastname: Nelson
authors.affiliation: Urology Department, Ghent University Hospital, Ghent, Belgium. Electronic address: an-sofie.Goessaert@uzgent.be.
authors.forename: An-Sofie
authors.initials: AS
authors.lastname: Goessaert
authors.affiliation: Urology Department, Ghent University Hospital, Ghent, Belgium.
authors.forename: Karel
authors.initials: K
authors.lastname: Everaert
mesh_terms: D001003:Anal Canal / Q000294:innervation / Q000503:physiopathology; D000818:Animals; D003248:Constipation / Q000503:physiopathology / Q000628:therapy*; D003672:Defecation / Q000502:physiology*; D004599:Electric Stimulation Therapy / Q000379:methods; D005242:Fecal Incontinence / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D012447:Sacrum; D013126:Spinal Nerve Roots; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology; D014554:Urination / Q000502:physiology*; D014570:Urologic Diseases / Q000503:physiopathology / Q000628:therapy*