Sacral nerve stimulation
(also known as sacral neuromodulaon) is a therapeutic method used for
bladder and bowel diseases. Its use was first reported by Tanagho and
Schmidt in 1988 for the treatment of urinary dysfunction.
Later on, utilization of sacral nerve stimulation for bowel
dysfunction was appreciated. In this method, stimulation of the sacral
nerve causes contraction of sphincters and pelvic floor
muscles, which in turn causes changes in the contraction patterns of
bladder or bowel.
Sacral neuromodulation involves the implantation of
a stimulator subcutaneously for delivering low amplitude
electrical stimulation via a lead to the sacral nerve, usually accessed
via the S3 or S4 foramen. The pulse generator is generally
placed in a subcutaneous pocket in the upper-outer quadrant of the
buttock or the lower abdomen.
For patients who interested in to receive this treatment, a testing is
required. During the testing, often referred to as peripheral nerve
evaluation (PNE), external electrical stimulation is delivered via a
temporary lead inserted percutaneously through the 3rd sacral foramen
to the S3 nerve. After a screening period of 2 to 3 weeks, the
patient’s response to treatment is assessed. For this
assessment, diaries and/or a questionnaires regarding bowel or
bladder functions are used. Then, if sufficient clinical improvement is
evident, the patient may be considered as eligible for permanent
Conditions which may be benefited from sacral nerve stimulation
Treatment of chronic anal fissure
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