A Joint Mechanism of Action for Sacral Neuromodulation for Bladder and Bowel Dysfunction?

Urology. 2016 Nov:97:13-19. doi: 10.1016/j.urology.2016.05.032. Epub 2016 May 24.

Abstract

Sacral neuromodulation (SNM) is a clinically effective intervention for treatment of urinary and bowel disorders. The aim is to establish the hypothesis that there is a common mechanism of action for SNM in both systems. Current knowledge includes the following: (1) Therapeutic parameters may be different for the 2 efficacy measures. (2) SNM invokes neural circuits that can be observed as neurochemical changes in specific neuroanatomic structures downstream from the therapy delivery site. (3) There are important central nervous system effects for both therapies. (4) Clinical observations regarding normal continence sensations as well as physiological measures of continence are different for the 2 therapy areas.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anal Canal / innervation
  • Anal Canal / physiopathology
  • Animals
  • Constipation / physiopathology
  • Constipation / therapy*
  • Defecation / physiology*
  • Electric Stimulation Therapy* / methods
  • Fecal Incontinence / physiopathology
  • Fecal Incontinence / therapy*
  • Humans
  • Sacrum
  • Spinal Nerve Roots
  • Urinary Bladder / innervation
  • Urinary Bladder / physiopathology
  • Urination / physiology*
  • Urologic Diseases / physiopathology
  • Urologic Diseases / therapy*