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Electrical neuromodulatory therapy in female voiding dysfunction
Author(s) -
BOSCH J.L.H. RUUD
Publication year - 2006
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2006.06316.x
Subject(s) - neuromodulation , medicine , sacral nerve stimulation , urinary retention , urinary incontinence , stimulation , electric stimulation therapy , surgery
Female voiding dysfunction such as urge‐frequency syndrome, urge incontinence and unobstructive urinary retention are often refractory to conservative management. Electrical neuromodulation with surface electrodes or with implantable systems has become a valuable addition to the therapeutic options in the last two decades. Interstitial cystitis is an emerging indication. The application of these techniques in non‐neurogenic patients is reviewed. The techniques using unimplantable electrodes, anogenital electrical stimulation with plug electrodes, transcutaneous electrical nerve stimulation with surface electrodes, and posterior tibial nerve stimulation using needle electrodes are addressed. Several techniques using implantable systems are discussed, e.g. sacral nerve neuromodulation (Interstim TM device), pudendal nerve stimulation (Interstim and Bion TM device) and paraurethral neuromodulation (Miniaturo TM device). The long‐term efficacy of neuromodulation for the established indications is more than half, but 20–50% of the patients initially tested do not respond to a test procedure. The disadvantage is the high surgical revision rate and the high cost of treatment. Technical advances will hopefully be able to address these aspects.