Neuromodulation for Voiding Dysfunction: When and How Best to Use

Abstract

Overactive bladder syndrome (OAB) symptoms and lower urinary tract dysfunction are often challenging to treat and have significant negative effect on the quality of life for many people. It lowers their self-esteem and health perception. The use of neuromodulation as a treatment has developed over the years and a lot of research has been done. This article will give an overview on neuromodulation treatment for OAB symptoms, including percutaneous tibial nerve stimulation (PTNS), sacral nerve stimulation (SNS), pudendal nerve stimulation (PNS), and dorsal genital nerve stimulation (DGNS). At this moment PTNS and SNS are widely adopted as a treatment with good results. PNS and DGNS stimulation seem to be promising for future use in clinical care. PTNS and SNS should be considered for treatment of OAB symptoms, especially in refractory OAB symptoms or when a patient experiences side effects of antimuscarinics. SNS therapy is more invasive and the costs are considerably higher, PNTS is less invasive and less expensive but more time consuming. The treatment modalities should be discussed with the patient and proper patient selection is mandatory.