Sacral and pudendal neuromodulation have been advocated for the treatment of refractory pelvic pain, urinary urgency and retention, as well as fecal incontinence or constipation, all of which are commonly related to endometriosis and/or its surgical treatment.
In this review, the mechanisms of action and different routes of neuromodulation will be detailed, as well as all the studied applications of neuromodulation on ameliorating symptoms related to endometriosis and/or its treatment.
International Neuromodulation Society. Neuromodulation, or neuromodulatory effect. Available from: www.neuromodulation.com. Accessed August 10, 2016.
2.
GabrielBNassifJTrompoukisP. Prevalence and outcome of urinary retention after laparoscopic surgery for severe endometriosis—does histology provide answers?Int Urogynecol J Pelvic Floor Dysfunct201223 (1) 111–116
3.
FanfaniFFagottiAGagliardiML. Discoid or segmental rectosigmoid resection for deep infiltrating endometriosis: a case-control study. Fertil Steril201094 (2) 444–449
4.
DeGroatWCYoshimuraNAnatomy and physiology of the lower urinary tract. In: Handbook of Clinical Neurology 3rd SeriesVol. 130, Ch 5. Oxford, UK: Elsevier. 2015:61-108.
5.
MauroyBDemondionXBizetBClaretAMestdaghPHurtCThe female inferior hypogastric (= pelvic) plexus: anatomical and radiological description of the plexus and its afferences—applications to pelvic surgery. Surg Radiol Anat200729 (1) 55–66
6.
WallnerCMaasCPDabhoiwalaNFLamersWHDeRuiterMCInnervation of the pelvic floor muscles: a reappraisal for the levator ani nerve. Obstet Gynecol20061083 Pt 1529–534
7.
GrigorescuBALazarouGOlsonTR. Innervation of the levator ani muscles: description of the nerve branches to the pubococcygeus, iliococcygeus, and puborectalis muscles. Int Urogynecol J Pelvic Floor Dysfunct200819 (1) 107–116
8.
PetrosPEUlmstenUIAn integral theory and its method for the diagnosis and management of female urinary incontinence. Scand J Urol Nephrol Suppl19931531–93
9.
CookTABradingAFMortensenNJThe pharmacology of the internal anal sphincter and new treatments of ano-rectal disorders. Aliment Pharmacol Ther200115 (7) 887–898
10.
PossoverMChianteraVBaekelandtJAnatomy of the Sacral Roots and the Pelvic Splanchnic Nerves in Women Using the LANN Technique. Surg Laparosc Endosc Percutan Tech200717 (6) 508–510
11.
FengBBrumovskyPRGebhartGFDifferential roles of stretch-sensitive pelvic nerve afferents innervating mouse distal colon and rectum. Am J Physiol Gastrointest Liver Physiol2010298 (3) G402–G409
GuytonACHallJEMembrane potentials and action potentials. In: Guyton AC, Hall JE, eds. Textbook of medical physiology 9th ed. Ch 5. Philadelphia: WB Saunders.199657–72
14.
SeolGHZiburkusJHuangS. Neuromodulators control the polarity of spike-timing-dependent synaptic plasticity. Neuron200755 (6) 919–929
15.
MalagutiSInterventional neurophysiology and an implantable system for neurostimulation of the sacral area. Funct Neurol200924 (4) 207–219
16.
PossoverMSchurchBHenleKPNew strategies of pelvic nerves stimulation for recovery of pelvic visceral functions and locomotion in paraplegics. Neurourol Urodyn201029 (8) 1433–1438
17.
QianSMDelaneyKRNeuromodulation of activity-dependent synaptic enhancement at crayfish neuromuscular junction. Brain Res1997771 (2) 259–270
18.
LogsdonSJohnstoneAFVieleKCooperRLRegulation of synaptic vesicles pools within motor nerve terminals during short-term facilitation and neuromodulation. J Appl Physiol (1985)2006100 (2) 662–671
19.
BlokBFGroenJBoschJLVeltmanDJLammertsmaAADifferent brain effects during chronic and acute sacral neuromodulation in urge incontinent patients with implanted neurostimulators. BJU Int200698 (6) 1238–1243
20.
ManivannanSTerakawaSRapid sprouting of filopodia in nerve terminals of chromaffin cells, PC12 cells, and dorsal root neurons induced by electrical stimulation. J Neurosci199414 (10) 5917–5928
21.
Brus-RamerMCarmelJBChakrabartySMartinJHElectrical stimulation of spared corticospinal axons augments connections with ipsilateral spinal motor circuits after injury. J Neurosci200727 (50) 13793–13801
22.
PossoverMRecovery of sensory and supraspinal control of leg movement in people with chronic paraplegia: a case series. Arch Phys Med Rehabil201495 (4) 610–614
23.
KellySLRadleySCBrownSRDoes percutaneous tibial nerve stimulation improve global pelvic function in women with faecal incontinence?Colorectal Dis201618 (5) O158–O163
24.
BerlandaNVercelliniPFedeleLThe outcomes of repeat surgery for recurrent symptomatic endometriosis. Curr Opin Obstet Gynecol201022 (4) 320–325
25.
ParkerJDLeondiresMSinaiiNPremkumarANiemanLKStrattonPPersistence of dysmenorrhea and nonmenstrual pain after optimal endometriosis surgery may indicate adenomyosis. Fertil Steril200686 (3) 711–715
26.
Dos BispoAPPlogerCLoureiroAF. Assessment of pelvic floor muscles in women with deep endometriosis. Arch Gynecol Obstet2016294 (3) 519–523
27.
JarrellJArendt-NielsenLEvolutionary considerations in the development of chronic pelvic pain. Am J Obstet Gynecol2016215 (2) 201.e1–201.e4
28.
EveraertKDevulderJDe MuynckM. The pain cycle: implications for the diagnosis and treatment of pelvic pain syndromes. Int Urogynecol J Pelvic Floor Dysfunct200112 (1) 9–14
29.
LaurettiGROliveiraRParadaFMattosALThe New Portable Transcutaneous Electrical Nerve Stimulation Device Was Efficacious in the Control of Primary Dysmenorrhea Cramp Pain. Neuromodulation201518 (6) 522–526 discussion 522-527.
30.
WangSFLeeJPHwaHLEffect of transcutaneous electrical nerve stimulation on primary dysmenorrhea. Neuromodulation200912 (4) 302–309
31.
BendañaEEBelarminoJMDinhJH. Efficacy of transvaginal biofeedback and electrical stimulation in women with urinary urgency and frequency and associated pelvic floor muscle spasm. Urol Nurs200929 (3) 171–176
32.
TirlapurSAVlismasABallEKhanKSNerve stimulation for chronic pelvic pain and bladder pain syndrome: a systematic review. Acta Obstet Gynecol Scand201392 (8) 881–887
33.
BiemansJMvan BalkenMREfficacy and effectiveness of percutaneous tibial nerve stimulation in the treatment of pelvic organ disorders: a systematic review. Neuromodulation201316 (1) 25–33 discussion 33.
34.
IstekAGungorUgurlucan FYasaCGokyildizSYalcinORandomized trial of long-term effects of percutaneous tibial nerve stimulation on chronic pelvic pain. Arch Gynecol Obstet2014290 (2) 291–298
35.
FarielloJYWhitmoreKSacral neuromodulation stimulation for IC/PBS, chronic pelvic pain, and sexual dysfunction. Int Urogynecol J Pelvic Floor Dysfunct201021 (12) 1553–1558
36.
SrivastavaDEfficacy of sacral neuromodulation in treating chronic pain related to painful bladder syndrome/interstitial cystitis in adults. J Anaesthesiol Clin Pharmacol201228 (4) 428–435
37.
MarinkovicSPGillenLMMarinkovicCMMinimum 6-year outcomes for interstitial cystitis treated with sacral neuromodulation. Int Urogynecol J Pelvic Floor Dysfunct201122 (4) 407–412
38.
MartellucciJNaldiniGCarrieroASacral nerve modulation in the treatment of chronic pelvic pain. Int J Colorectal Dis2012A 27 (7) 921–926
39.
MartellucciJNaldiniGDel PopoloGCarrieroASacral nerve modulation in the treatment of chronic pain after pelvic surgery. Colorectal Dis2012B 14 (4) 502–507
40.
CarmelMLebelMTuMPudendal nerve neuromodulation with neurophysiology guidance: a potential treatment option for refractory chronic pelvi-perineal pain. Int Urogynecol J Pelvic Floor Dysfunct201021 (5) 613–616
41.
HeinzeKHoermannRFritschHDermietzelRvan OphovenAComparative pilot study of implantation techniques for pudendal neuromodulation: technical and clinical outcome in first 20 patients with chronic pelvic pain. World J Urol201533 (2) 289–294
42.
PetersKMFeberKMBennettRCA prospective, single-blind, randomized crossover trial of sacral vs pudendal nerve stimulation for interstitial cystitis. BJU Int2007100 (4) 835–839
43.
PetersKMKillingerKAJaegerCChenCPilot Study Exploring Chronic Pudendal Neuromodulation as a Treatment Option for Pain Associated with Pudendal Neuralgia. Low Urin Tract Symptoms20157 (3) 138–142
44.
BuffenoirKRioultBHamelOLabatJJRiantTRobertRSpinal cord stimulation of the conus medullaris for refractory pudendal neuralgia: a prospective study of 27 consecutive cases. Neurourol Urodyn201534 (2) 177–182
45.
AbbottJAJarvisSKLyonsSDThomsonAVancailleTGBotulinum toxin type A for chronic pain and pelvic floor spasm in women: a randomized controlled trial. Obstet Gynecol2006108 (4) 915–923
46.
Nesbitt-HawesEMWonHJarvisSKLyonsSDVancaillieTGAbbottJAImprovement in pelvic pain with botulinum toxin type A - Single vs. repeat injections. Toxicon20136383–87
47.
AdelowoAHackerMRShapiroAModestAMElkadryEBotulinum toxin type A (BOTOX) for refractory myofascial pelvic pain. Female Pelvic Med Reconstr Surg201319 (5) 288–292
48.
MorrisseyDEl-KhawandDGinzburgNWehbeSO'HarePIIIWhitmoreKBotulinum Toxin A Injections Into Pelvic Floor Muscles Under Electromyographic Guidance for Women With Refractory High-Tone Pelvic Floor Dysfunction: A 6-Month Prospective Pilot Study. Female Pelvic Med Reconstr Surg201521 (5) 277–282
49.
PetersKMKillingerKABoguslawskiBMBouraJAChronic pudendal neuromodulation: expanding available treatment options for refractory urologic symptoms. Neurourol Urodyn201029 (7) 1267–1271
50.
BallesterMChereauEDubernardGCoutantCBazotMDaraïEUrinary dysfunction after colorectal resection for endometriosis: results of a prospective randomized trial comparing laparoscopy to open surgery. Am J Obstet Gynecol2011204 (4) 303.e1–303.e6
51.
DubernardGRouzierRDavid-MontefioreEBazotMDaraïEUrinary complications after surgery for posterior deep infiltrating endometriosis are related to the extent of dissection and to uterosacral ligaments resection. J Minim Invasive Gynecol200815 (2) 235–240
52.
PeetersKSahaiADe RidderDVan DerAa FLong-term follow-up of sacral neuromodulation for lower urinary tract dysfunction. BJU Int2014113 (5) 789–794
53.
ElneilSAbtahiBHelalMDigesuAGonzalesGOptimizing the duration of assessment of stage-1 sacral neuromodulation in nonobstructive chronic urinary retention. Neuromodulation201417 (1) 66–70 discussion 70-71.
54.
DattaSNChalihaCSinghA. Sacral neurostimulation for urinary retention: 10-year experience from one UK centre. BJU Int2008101 (2) 192–196
55.
De RidderDOstDBruyninckxFThe presence of Fowler's syndrome predicts successful long-term outcome of sacral nerve stimulation in women with urinary retention. Eur Urol200751 (1) 229–233 discussion 233-234.
56.
DenzingerSNowrotekAWeingartP. Does sacral neuromodulation lead to relevant reduction in the need for intermittent catheterization? A single-center experience on patients with chronic urinary retention. Neuromodulation201215 (6) 586–591 discussion 591.
57.
DasguptaRWisemanOJKitchenNFowlerCJLong-term results of sacral neuromodulation for women with urinary retention. BJU Int200494 (3) 335–337
58.
SiegelSWCatanzaroFDijkemaHE. Long-term results of a multicenter study on sacral nerve stimulation for treatment of urinary urge incontinence, urgency-frequency, and retention. Urology2000566 Suppl 187–91
59.
CunninghamKGWestneyOLSacral Neuromodulation for the Treatment of Retention in Partial Sacrectomy Patients. Neuromodulation2016 Jun 13. doi: 10.1111/ner.12455. [Epub ahead of print]
60.
LombardiGMuscoSCelsoM. Intravesical electrostimulation versus sacral neuromodulation for incomplete spinal cord patients suffering from neurogenic non-obstructive urinary retention. Spinal Cord201351 (7) 571–578
61.
NyangohTimoh KCanlorbeGVerolletD. Contribution of sacral neuromodulation to manage persistent voiding dysfunction after surgery for deep infiltrating endometriosis with colorectal involvement: preliminary results. Eur J Obstet Gynecol Reprod Biol201519031–35
62.
PossoverMQuakernackJChianteraVThe LANN technique to reduce postoperative functional morbidity in laparoscopic radical pelvic surgery. J Am Coll Surg2005201 (6) 913–917
63.
LemosNSouzaCMarquesRMKamergorodskyGSchorEGirãoMJLaparoscopic anatomy of the autonomic nerves of the pelvis and the concept of nerve-sparing surgery by direct visualization of autonomic nerve bundles. Fertil Steril2015104 (5) e11–e12
64.
PossoverMPathophysiologic explanation for bladder retention in patients after laparoscopic surgery for deeply infiltrating rectovaginal and/or parametric endometriosis. Fertil Steril2014B 101 (3) 754–758 Published online January 11, 2014.
65.
KuoTLNgLGChappleCRPelvic floor spasm as a cause of voiding dysfunction. Curr Opin Urol201525 (4) 311–316
66.
GrossCHabliMLindsellCSouthMSacral neuromodulation for nonobstructive urinary retention: a meta-analysis. Female Pelvic Med Reconstr Surg201016 (4) 249–253
67.
GazievGTopazioLIacovelliV. Percutaneous Tibial Nerve Stimulation (PTNS) efficacy in the treatment of lower urinary tract dysfunctions: a systematic review. BMC Urol201313 (1) 61
68.
ZinkgrafKQuinnAOKetterhagenDKreuzigerBStevensonKPercutaneous tibial nerve stimulation for treatment of overactive bladder and urinary retention in an elderly population. Urol Nurs200929 (1) 30–34
69.
PossoverMChianteraVNeuromodulation of the superior hypogastric plexus: a new option to treat bladder atonia secondary to radical pelvic surgery?Surg Neurol200972 (6) 573–576
70.
SobockiJNowakowskiMHermanRM. Laparoscopically implanted system for stimulation of the hypogastric plexus induces colonic motility, defecation, and micturition: experimental study. Surg Innov201522 (1) 70–76
71.
DubernardGPikettyMRouzierRHourySBazotMDaraiEQuality of life after laparoscopic colorectal resection for endometriosis. Hum Reprod200621 (5) 1243–1247
72.
Armengol-DebeirLSavoyeGLeroiAM. Pathophysiological approach to bowel dysfunction after segmental colorectal resection for deep endometriosis infiltrating the rectum: a preliminary study. Hum Reprod201126 (9) 2330–2335
73.
KoninckxPRUssiaAAdamyanLWattiezADonnezJDeep endometriosis: definition, diagnosis, and treatment. Fertil Steril201298 (3) 564–571
74.
RomanHVassilieffMTuechJJ. Postoperative digestive function after radical versus conservative surgical philosophy for deep endometriosis infiltrating the rectum. Fertil Steril201399 (6) 1695–1704
75.
KamergorodskyGLemosNRodriguesFC. Evaluation of pre- and post-operative symptoms in patients submitted to linear stapler nodulectomy due to anterior rectal wall endometriosis. Surg Endosc201529 (8) 2389–2393
76.
AbrãoMSPetragliaFFalconeTKecksteinJOsugaYChapronCDeep endometriosis infiltrating the recto-sigmoid: critical factors to consider before management. Hum Reprod Update201521 (3) 329–339
77.
MaedaYO'ConnellPRLehurPAMatzelKELaurbergSEuropean SNS Bowel Study Group. Sacral nerve stimulation for faecal incontinence and constipation: a European consensus statement. Colorectal Dis201517 (4) O74–O87
78.
MuscoSSeratiMLombardiG. Percutaneous Tibial Nerve Stimulation Improves Female Sexual Function in Women With Overactive Bladder Syndrome. J Sex Med201613 (2) 238–242
79.
LombardiGFinazziAgrò EDel PopoloGSacral neuromodulation and female sexuality. Int Urogynecol J Pelvic Floor Dysfunct201526 (12) 1751–1757
80.
BanakharMGazwaniYKeliniMEAl-ShaijiTHassounaMEffect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?Can Urol Assoc J2014811-12E762–E767
81.
ParnellBAHowardJFJrGellerEJThe effect of sacral neuromodulation on pudendal nerve function and female sexual function. Neurourol Urodyn201534 (5) 456–460
82.
PetersKMPudendal neuromodulation for sexual dysfunction. J Sex Med201310 (4) 908–911
83.
van VoskuilenACOerlemansDJGielenN. Sexual response in patients treated with sacral neuromodulation for lower urinary tract symptoms or fecal incontinence. Urol Int201288 (4) 423–430
84.
JadavAMWadhawanHJonesGLWheldonLWRadleySCBrownSRDoes sacral nerve stimulation improve global pelvic function in women?Colorectal Dis201315 (7) 848–857
85.
SignorelloDSeitzCCBernerL. Impact of sacral neuromodulation on female sexual function and his correlation with clinical outcome and quality of life indexes: a monocentric experience. J Sex Med20118 (4) 1147–1155
86.
FacioFJrBurnettALPenile rehabilitation and neuromodulation. ScientificWorldJournal20099652–664
87.
IngberMSIbrahimIAKillingerKADioknoACPetersKMNeuromodulation and female sexual function: does treatment for refractory voiding symptoms have an added benefit?Int Urogynecol J Pelvic Floor Dysfunct200920 (9) 1055–1059
88.
LombardiGMondainiNMacchiarellaACilottiADel PopoloGClinical female sexual outcome after sacral neuromodulation implant for lower urinary tract symptom (LUTS). J Sex Med20085 (6) 1411–1417
89.
ZabihiNMourtzinosAMaherMGRazSRodríguezLVThe effects of bilateral caudal epidural S2-4 neuromodulation on female sexual function. Int Urogynecol J Pelvic Floor Dysfunct200819 (5) 697–700
90.
van BalkenMRVergunstHBemelmansBLSexual functioning in patients with lower urinary tract dysfunction improves after percutaneous tibial nerve stimulation. Int J Impot Res200618 (5) 470–475 discussion 476. Erratum in: Int J Impot Res. 2006;18(6):577. Verguns, H [corrected to Vergunst, H].
