Sacral Neuromodulation for Urinary and Fecal Incontinence

  • Maria Angela CerrutoEmail author
  • Alessandra Masin
Part of the Urodynamics, Neurourology and Pelvic Floor Dysfunctions book series (UNPFD)


Sacral neuromodulation (SNM), also termed sacral nerve stimulation (SNS), is an established treatment modality for patients with chronic lower urinary tract dysfunction (LUTD). Since the late 1980s, this therapy has evolved in an effective but mainly empirical way, and the precise mechanism of its action is still unknown. The United States (US) Food and Drug Administration (FDA) has approved the following indication for patients with chronic LUTD, refractory to appropriate conventional treatments: urge urinary incontinence, urgency-frequency syndrome and dysfunctional voiding with non-obstructive urinary retention. SNM has become an established therapy also for anorectal disorders such as faecal incontinence.


  1. 1.
    Noblett K. Neuromodulation and female pelvic disorders. Curr Opin Urol. 2016;26:321–7.CrossRefGoogle Scholar
  2. 2.
    Siegel S, Noblett K, Mangel J, et al. Three-year follow-up results of a prospective, multicenter study in overactive bladder subjects treated with sacral neuromodulation. Urology. 2016;94:57–63.CrossRefGoogle Scholar
  3. 3.
    Altomare DF, Giuratrabocchetta S, Knowles CH, et al. Long-term outcomes of sacral nerve stimulation for faecal incontinence. Br J Surg. 2015;102:407–15.CrossRefGoogle Scholar
  4. 4.
    Matzel KE, Chartier-Kastler E, Knowles CH, et al. Sacral Neuromodulation: Standardized Electrode Placement Technique. Neuromodulation. 2017;20:816–24.CrossRefGoogle Scholar
  5. 5.
    Siegel SW. Sacral nerve stimulation. In: Jonas U, Grünewald V, editors. New perspective in sacral nerve stimulation. London: Martin Dunitz of the Taylor & Francis Group; 2002. p. 99–106. ISBN 1-84184-114-5.Google Scholar
  6. 6.
    Maeda Y, O’Connell R, Lehur PA, Matzel KE, Laurberg S, European SNS Bowel Study Group. Sacral nerve stimulation for faecal incontinence and constipation: a European consensus statement. Color Dis. 2015;17:O74–87.CrossRefGoogle Scholar
  7. 7.
    Leroi AM, Damon H, Faucheron JL, et al. Sacral nerve stimulation in faecal incontinence: position statement based on a collective experience. Color Dis. 2009;11:572–83.CrossRefGoogle Scholar
  8. 8.
    Maeda Y, Lundby L, Buntze S, Laurberg S. Outcome of sacral nerve stimulation for fecal incontinence at 5 years. Ann Surg. 2014;259:1126–31.CrossRefGoogle Scholar
  9. 9.
    Shakuri-Rad J, Cicic A, Thompson J. Prospective randomized study evaluating ultrasound versus fluoroscopy guided sacral InterStim® lead placement: a pilot study. Neurourol Urodyn. 2018;37(5):1737–43.CrossRefGoogle Scholar
  10. 10.
    Hellström PA, Katisko J, Finnilä P, Vaarala MH. Sacral nerve stimulation lead implantation using the o-arm. BMC Urol. 2013;13:48.CrossRefGoogle Scholar
  11. 11.
    Gumber A, Ayyar S, Varia H, Pettit S. Presacral abscess as a rare complication of sacral nerve stimulator implantation. Ann R Coll Surg Engl. 2017;99:e104–7.CrossRefGoogle Scholar
  12. 12.
    Pizzarro-Berichevsky J, Gill BC, Clifton M, Okafor HT, Faris AE, Vasavada SP, Goldman HB. Motor response matters: optimizing lead placement improves sacral neuromodulation outcomes. J Urol. 2018;199:1032–6.CrossRefGoogle Scholar
  13. 13.
    Myer ENB, Petrikovets A, Slocum PD, Lee TG, et al. Risk factors for explantation due to infection after sacral neuromodulation: a multicenter retrospective case-control study. Am J Obstet Gynecol. 2018;219(1):78.e1–9.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Urology Clinic, Department of Surgery, Dentistry, Paediatrics and GynaecologyUniversity of VeronaVeronaItaly
  2. 2.Surgery Clinic 1University of PaduaPaduaItaly

Personalised recommendations