ABSTRACT
Lower urinary tract function is governed by a complex neural control mechanism involving the autonomic and central nervous systems. Neuromodulation's precise mechanism of action in treating OAB and NOUR is unknown. SNM is indicated in women with OAB refractory to conservative and pharmacological treatments, as well as in patients with NOUR. SNM has demonstrated its utility in idiopathic nonobstructive retention, as well as retention secondary to deafferentation of the bladder after pelvic surgery and in Fowler syndrome. SNM is a safe surgical procedure, but preoperative counseling on potential adverse events is advised. Regardless of the indications and devices used, SNM patients will require close and continuous follow-up to ensure that the efficacy is sustained, that the device functions properly, and that there are no device-related adverse events. Although SNM originated over 50 years ago, more study is needed to better elucidate its putative mechanism of action. Clinically, it has a meaningful role in the treatment of refractory OAB and NOUR.
