Expert Opinion

The future of the Sacral Nerve Stimulation

  • MICHELE SPINELLI

Pelviperineology 2007;26(1):17-18

Over the last ten years sacral nerve stimulation has shown great potential in the treatment of pelvic dysfunction. Initially used to treat urinary symptoms it has recently also been used to treat fecal incontinence and constipation. The technique has been refined, by introducing a minimally invasive percutaneous two stage implantation, so that patients can undergo a prolongued test stimulation using a permanent lead. Accurate neurophysiological evaluation can now be performed before, during, and after implantation and this has confirmed improved treatment success rates. Current studies are investigating the efficacy of new treatment systems, based on both direct and indirect sacral root stimulation, and in the future other systems modulating the central control mechanisms and directly stimulating the sacral nerve roots on demand.

Keywords: Sacral neurostimulation; Permanent lead; Incontinence; Direct and indirect stimulation; Functional assessment.