Efficacy of sacral neuromodulation and percutaneous tibial nerve stimulation in the treatment of chronic nonobstructive urinary retention: A systematic review

2021 ◽  
Author(s):  
Felicia Ching Siew Ho ◽  
Carl He ◽  
Henry Han‐I Yao ◽  
Helen E. O'Connell ◽  
Johan Gani
Keyword(s):  
Systematic Review ◽  
Urinary Retention ◽  
Nerve Stimulation ◽  
Sacral Neuromodulation ◽  
Tibial Nerve ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Tibial Nerve Stimulation

Neuromodulation in urology, state of the art

2019 ◽  
Vol 86 (4) ◽  
pp. 177-182 ◽  
Author(s):  
Enrico Ammirati ◽  
Alessandro Giammò ◽  
Alberto Manassero ◽  
Roberto Carone
Keyword(s):  
Nerve Stimulation ◽  
Sacral Neuromodulation ◽  
Tibial Nerve ◽  
Leg Pain ◽  
Current Evidence ◽  
Percutaneous Tibial Nerve Stimulation ◽  
Invasive Approach ◽  
Tibial Nerve Stimulation ◽  
Less Invasive Approach ◽  
Third Line

Sacral neuromodulation is an approved and validated treatment for overactive bladder syndrome, chronic non-obstructive retention, and chronic pelvic pain. Percutaneous tibial nerve stimulation is a less invasive approach of neuromodulation. We performed a literature research to assess the current evidence available about neuromodulation. Both techniques appear to be effective and safe third-line treatments. The overall success rate ranges from 43% to 85% for sacral neuromodulation and from 40% to 79.5% for percutaneous tibial nerve stimulation. Sacral neuromodulation has a higher incidence of complications in comparison to percutaneous tibial nerve stimulation, due to the more invasive surgical technique and the presence of a permanent implant. The incidence of surgical revision ranges between 9% and 33%. The most frequent complication with sacral neuromodulation is pain at implant site (15%–42%), followed by lead migration (4%–21%), pain at lead site (5.4%–19.1%), leg pain (18%), and infection (5.7%–6.1%). The quality of the studies on sacral neuromodulation and percutaneous tibial nerve stimulation in literature is quite modest, because of the shortage of good randomized clinical trial; most of the studies are prospective observational studies with mid-term follow-up.

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