Neuromodulation and female pelvic disorders.

PURPOSE OF REVIEW: Sacral neuromodulation is a Food and Drug administration approved therapy for the treatment of refractory overactive bladder, urinary retention, and fecal incontinence. The objective of this manuscript is to review the recent literature regarding clinical outcome data and current management strategies for sacral neuromodulation.

RECENT FINDINGS: There have been significant advances in therapy techniques as well as long-term data supporting this therapy for both urinary and fecal incontinence. These include the InSite trial and the long-term follow-up of the fecal incontinence registry trial. In addition, the development of surgical techniques to reduce infection, improvements in programmability of the implantable pulse generator, as well as deciding on best stimulation parameters will be discussed. Finally, introduction of a new animal model to test a chronically implanted lead and stimulator in a large animal model opens the door to many future studies.

SUMMARY: These data help to inform us on the most recent clinical outcomes for sacral neuromodulation, as well as recommendations for best practices for implant technique.