This long-term study demonstrates that InterStim therapy is safe and effective for restoring voiding in appropriately selected cases refractory to other forms of treatment.

No abstract

Neuromodulation of the sacral nerves is an effective, safe therapy that successfully treats significant symptoms of refractory urgency-frequency.

Sacral nerve stimulation is safe and effective in treating refractory urinary urge incontinence.

Results of this prospective, randomized clinical study demonstrate that sacral nerve stimulation is effective for restoring voiding in patients with retention who are refractory to other forms of treatment.

Sacral nerve stimulation is safe and effective in treating refractory urinary urge incontinence.

Sacral root neuromodulation is an appealing modality for treatment of urge incontinence refractory to conventional pharmacotherapy. The relative simplicity of the technique, promising results and low complication rate make this therapy a likely alternative.

ResultsThe present recommendations, based on the most relevant data available in the literature, as well as expert opinion, address a variety of specific and at times problematic issues associated with SNM. These include the use of SNM for a variety of underlying conditions, need for pre-procedural testing, use of staged vs single-stage procedures, screening for success during the trial phase, ideal anesthesia, device implantation, post-procedural management, trouble-shooting loss of device function, and future directions for research. Conclusions:These guidelines undoubtedly constitute a reference document, which will help urologists, gynecologists, and colorectal surgeons optimize their use of SNM for refractory urinary urgency and frequency, UUI, NOR, and FI.• Eight urologists, three colorectal surgeons and two urogynecologists, covering a wide breadth of geographic and specialty interest representation, met for two days in Chicago, Illinois, USA on January 19-20, 2017 to discuss best practices for neuromodulation. Suggestions for statements were submitted in advance and specific topics were assigned to committee members. Committee members prepared each assigned topic and presented supporting data to the group at which time each topic was discussed in depth. Best practice statements were formulated based on available data and expert opinion and then each member prepared a discussion section for each particular topic which reflected the current literature and expert opinion. Another urologist was added to the group during the initial writing process. After multiple rounds of editing within the group the highlights of the statements were presented at the ICS meeting in Florence, Italy in September 2017. This document was then circulated to multiple external reviewers after which final edits were made and approved by the group.• The meeting and editing expenses were supported by the ICS. Funding to support this project was based on an unrestricted society-initiated grant made by Medtronic to the ICS.• As many of the recommendations herein are based on expert panel consensus, the recommendations in this document, while meant to aid clinical decision-making, do not preempt physician judgment in individual cases.The statements and recommendations included in this document pertain to SNM in its present form (Interstim, Medtronic) They may or may not have relevance for future SNM products or therapies which become available for clinical use.