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Sacral Nerve Stimulation as a Therapy for Patients With Refractory Voiding and Bowel Dysfunction

Noblett, Karen L., MD; Buono, Kristen, MD

doi: 10.1097/AOG.0000000000002968
Contents: Urogynecology: Clinical Expert Series
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Sacral nerve stimulation delivers nonpainful electrical pulses to the sacral nerves that modulate the reflexes that control the bladder, bowels, and pelvic floor musculature. This relatively simple procedure was generated to improve and restore function in patients with a variety of pelvic floor disorders. Currently this therapy is approved for use in patients with urgency urinary incontinence, urinary urgency–frequency, nonobstructive urinary retention, and fecal incontinence. This review includes the history of this treatment modality, explains the mechanism of action, and describes the procedure for implantation of this device. Additionally, advancements in this treatment over the past two decades and landmark literature to date regarding sacral nerve stimulation are reviewed. Current literature regarding off-label uses of this treatment modality for a variety of pelvic floor disorders is also discussed.

Sacral nerve stimulation for refractory voiding and bowel dysfunction has provided an effective minimally invasive therapy for patients for whom more conservative treatments have failed.

Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, University of California Irvine, Orange, California.

Corresponding author: Karen L. Noblett, MD, 333 City Boulevard West, Suite 1400, Orange, CA 92868; email:

Financial Disclosure Dr. Noblett is the Chief Medical Officer for Axonics Modulation Technologies, Inc. The other author did not report any potential conflicts of interest.

Continuing medical education for this article is available at

Each author has indicated that she has met the journal's requirements for authorship.

Received December 13, 2017

Received in revised form February 11, 2018

Accepted April 26, 2018

© 2018 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.