Improving Quality of Life with Neuromodulation: A Novel Treatment for Incontinence

Dean Elterman, MD, FRCSC,1 Co-author: Brandon Van Asseldonk B. Eng 2

1Assistant Professor, University of Toronto, Toronto Western Hospital, Toronto, ON.

2Faculty of Medicine, University of Toronto, Toronto, ON.

CLINICAL TOOLS

Abstract: Sacral neuromodulation (SNM) is Health Canada authorized for the management of chronic intractable (functional) disorders of the pelvis and lower urinary or intestinal tract. A minimally invasive procedure, it has excellent symptom reduction and quality of life improvement in carefully selected patients and its effects are shown to be of extended duration in long-term follow up.
Key Words: sacral neuromodulation, overactive bladder, urge incontinence, fecal incontinence.

Sacral neuromodulation (SNM) is peripheral nerve stimulation used for the treatment of overactive bladder (OAB) and fecal incontinence.
SNM is recommended by both the American Urological Association (AUA) and the Canadian Urological Association (CUA) as third-line therapy for the treatment of OAB.
Given the large number of implantations and history of SNM, improvements in urinary symptoms are established and of long duration in those who respond to treatment.
SNM use in patients with fecal incontinence is more recent, but several large studies have demonstrated significant improvement in symptoms.
Fecal incontinence and overactive bladder are both debilitating medical conditions that can impair quality of life and limit day-to-day activities.
Sacral neuromodulation is authorized by Health Canada and the FDA as treatment for both bladder and bowel conditions.
SNM is a minimally invasive out-patient surgery that has consistently been demonstrated to improve symptoms and quality of life in patients with OAB or fecal incontinence.
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This article was published as part of Managing the Health of Your Aging Patient: Therapies that Could Help Improve Quality of Life eCME resource.
The development of Managing the Health of Your Aging Patient: Therapies that Could Help Improve Quality of Life eCME resource was supported by an educational grant from Medtronic Canada.