Sacral Neuromodulation for the Treatment of Pelvic Floor Disorders
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Purpose of Review
Sacral neuromodulation (SNM) is an FDA-approved treatment option for several refractory pelvic floor disorders given its efficacy and safety profile. Over the past several years, numerous papers have been published on SNM’s long-term outcomes, emerging new indications, comparisons with other treatment options, and cost effectiveness. Therefore, we aim to review these updates to the SNM literature.
A PUBMED® and MEDLINE® search was performed for scientific publications on “sacral neuromodulation” and “sacral nerve stimulation” between 2011 and 2016. Recent evidence has shown that improved objective and subjective outcomes following placement of SNM are sustained over 3–5 years in the treatment of overactive bladder symptoms and fecal incontinence with minimal adverse events. SNM has also had promising results when used in the treatment of chronic pelvic pain, interstitial cystitis/painful bladder syndrome, constipation, and neurogenic bladder although larger, prospective trials with long-term evaluation are needed to truly establish SNM as an effective intervention for these expanding indications.
SNM is a well-tolerated intervention for refractory bladder and bowel dysfunction with recent long-term longitudinal studies confirming its efficacy and safety. As we gain further insight into SNM’s mechanism of action and broader therapeutic indications, we anticipate SNM will become even more widely utilized in the treatment of complex pelvic floor disorders.
KeywordsSacral neuromodulation Interstim Overactive bladder Pelvic floor disorders Insite trial
Compliance with Ethical Standards
Conflict of Interest
Dr. Karen L. Noblett is a consultant for Medtronic. Dr. Sonia Dutta declares no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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