CIC Adjunctive Therapy for SNM Patients

With the development of medical technology, sacral nerve stimulation (SNS), also known as sacral neuromodulation (SNM), has become another new technology for treating voiding dysfunction. The concept of SNM treatment for voiding dysfunction can be traced back to the 1960s. With the successful application of cardiac pacemakers, people began to try to stimulate other organs of the body through electrical stimulation. In 1979, Schmidt and others conducted animal experiments on SNM in the United States, and in 1981, they initiated a clinical research program on SNM [1]. In Europe, in 1994, SNM was certified by the European community and applied to clinical practice [2]; in the same year, Matzel and others reported the successful experience of SNM in patients with fecal incontinence [3]. In the United States, in 1997, the FDA approved SNM for the treatment of urge incontinence, and in 1999, it was approved for the treatment of frequency-urgency syndrome and urinary retention [2]. Through the continuous efforts and attempts of scholars, in the past decade or so, SNM has undergone tremendous technological updates, including barbed electrodes, intraoperative X-ray fluoroscopy technology, and the application of small stimulators [4]. In 2006, the Interstim II stimulator is used in Europe and America. The volume and weight of the Interstim II stimulator are more than 50% less than those of the Interstim I stimulator, and it can be directly connected to the electrode without the need for extension wires, making permanent implantation simpler and more minimally invasive [5]. As SNM has been successful in treating various refractory urinary disorders, the advantages of this technology have gradually emerged, making more and more urologists begin to pay attention to this technology; thus many indications for CIC have been replaced by SNM, or CIC and SNM are combined to play their respective advantages [6]. The application of SNM in CIC patients can not only increase the patient’s ability to urinate autonomously, reduce the patient’s PVR, but also extend the interval of CIC, improving the patient’s quality of life [7].