Neuromodulation: A new frontier?

Abstract

It is often impossible to identify the precise cause of urethrocystalgia at radiological and functional confirmation of diagnosis and therapy is therefore frequently symptomatic without resolving the underlying cause. Neuromodulation by stimulating the sacral nerves of the vertebral foramina has recently been introduced into clinical practice. At present only a few specialised centres have implemented this therapy as second choice in treating lower urinary tract dysfunction secondary to detrusorial hyper- or hypoactivity and pelvic pain. The authors review literature on the subject and report on the multi-centre experience of Brescia, Padua and Treviso in treating urethrocystalgias. A method has been used that is by now standardised with regard to temporary percutaneous stimulation techniques and final implant. Ways of correctly identifying predictive factors which would indicate suitability for application of the method are, however, still unclear. It is to be hoped that studies involving larger numbers of cases may provide the answers, so that specialists can apply the technique more correctly.