Neurology India
menu-bar5 Open access journal indexed with Index Medicus
  Users online: 1432  
 Home | Login 
About Editorial board Articlesmenu-bullet NSI Publicationsmenu-bullet Search Instructions Online Submission Subscribe Videos Etcetera Contact
  Navigate Here 
 »   Next article
 »   Previous article
 »   Table of Contents

 Resource Links
 »   Similar in PUBMED
 »Related articles
 »   Citation Manager
 »   Access Statistics
 »   Reader Comments
 »   Email Alert *
 »   Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded44    
    Comments [Add]    
    Cited by others 1    

Recommend this journal


Year : 2020  |  Volume : 68  |  Issue : 8  |  Page : 307--315

Neuromodulation for Restoration of Urinary and Bowel Control

Director, Urology and Renal Transplantation, Pelvic Floor and Neuro-Urology Clinic, Jaslok Hospital and Research Centre; Senior Visiting Urologis, Sir H.N. Reliance Hospital, Lilavati Hospital, Breach Candy Hospital and Wockhardt Hospital, Mumbai, Maharashtra, India

Correspondence Address:
Shailesh Raina
Director, Urology and Renal Transplantation, Pelvic Floor and Neuro-Urology Clinic, Jaslok Hospital and Research Centre, Mumbai, Maharashtra
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0028-3886.302457

Rights and Permissions

Control of the lower urinary tract is a complex, multilevel process that involves the peripheral and central nervous systems. Patients with spinal cord diseases or injuries present with multiple bladder and bowel problems. The commonest are urinary, urgency, frequency, urge incontinence, retention and/or fecal incontinence. Though the first reports of neurostimulation to empty bladder came in 1970s’, it was only in 1988 that Schmidt and Tanagho restarted discussion and application of neuromodulation and electrical stimulation of sacral nerve in urology. In April, 1999 - FDA approved the InterStim System for treatment of symptoms of urgency-frequency and urinary retention. In October 2000, Medtronic Commercial Release for SNS-Bowel was approved. In October 2002, the Tined lead was launched and N’Vision programmer was launched in the official market in Europe. SNM is now considered the third line of management in refractory cases of OAB, chronic NOUR, frequency and urgency. Role in neuropathic bladder is still being assessed. SNM includes a thorough preoperative assessment, PNE (Percutaneous Nerve Evaluation) without any muscle relaxation and finally installation of a permanent IPG after assessing reponse. We have an experience of over 20 patients in last 11 years. These include patients of refractory OAB, chronic NOUR and Cauda Equina Syndrome. We do a two-staged procedure in view of the high cost and abide by the AUA, EAU and ICS guidelines. Our long term results for neuropathic OAB are awaited.


Print this article     Email this article

Online since 20th March '04
Published by Wolters Kluwer - Medknow