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Neuromodulation in Neurourology

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Neuro-Urology

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Abstract

Data suggests that peripheral and sacral neuromodulation are minimally invasive surgical interventions to address and improve both urinary and bowel symptoms in patients with neurogenic bladder and/or bowel. There is lack of level one evidence and there is moderate data supporting the use of these therapies to address overactive bladder symptoms in patients with neurogenic bladder. There is still controversy about their utility for urinary retention, and data is limited regarding treatment of neurogenic bowel. Limitations include small sample size, heterogeneous neurologic etiologies of study populations, and measurement of different outcomes, and most studies are retrospective analyses. Nonetheless more contemporary data suggests promising outcomes in specific situations that could statistically and clinically improve urinary and bowel symptoms in patients with spinal cord injury and multiple sclerosis. Current research is studying the effect of early utilization of sacral neuromodulation after spinal cord injury. Targeting of specific stages of a neurologic injury will address the question of who is an optimal candidate and may ultimately benefit from this intervention. Avoiding the neurologic impairment that occurs at the bladder and bowel level may prevent detrimental changes in organ physiology and improve symptoms in the long term.

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Authors and Affiliations

  1. Division of Neurourology and Pelvic Reconstruction, Department of Urology, University of Michigan, Ann Arbor, MI, USA

    Paholo G. Barboglio Romo & Priyanka Gupta

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  1. Paholo G. Barboglio Romo
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  2. Priyanka Gupta
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Correspondence to Priyanka Gupta .

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Editors and Affiliations

  1. Department of Urology, Vanderbilt University Medical Center, Nashville, TN, USA

    Roger Dmochowski

  2. Department of Urology, Radboud University, Nijmegen, The Netherlands

    John Heesakkers

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Romo, P.G.B., Gupta, P. (2018). Neuromodulation in Neurourology. In: Dmochowski, R., Heesakkers, J. (eds) Neuro-Urology. Springer, Cham. https://doi.org/10.1007/978-3-319-90997-4_25

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  • DOI: https://doi.org/10.1007/978-3-319-90997-4_25

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