Neuromodulation for urinary dysfunction

The use of neuromodulation in the treatment of voiding dysfunction and other disorders has become an important mode of therapy in urology. As use of this therapy has increased, the body of knowledge about the physiology of micturition has grown and the technology in nerve stimulation has improved. Sacral nerve stimulation is the most frequently used form of neuromodulation, although other nerve stimulation modalities continue to be developed. Although neuromodulation is an effective treatment, the exact mechanism of action is unknown. As more light is shed on the appropriate patient selection and eventual treatment factors that best respond to neuromodulation, this therapy likely will be used earlier in the treatment course and with greater success. Use of pharmacologic agents such as botulinum toxin type A for chemical neuromodulation may also play an important role in the management of voiding dysfunction.