Professional Statements and Societal Positions Guidelines
Urinary Disorders
American Urological Association - 2014
The American Urological Association (2014) updated its guidelines on the diagnosis and treatment of overactive bladder. The guidelines stated that sacral neuromodulation may be offered as a third-line treatment in carefully selected individuals with severe refractory symptoms or into those who are not candidates for second-line therapy (e.g., oral antimuscarinics, oral β3-adrenoceptor agonists, transdermal oxybutynin) and are willing to undergo surgery.
American College of Obstetricians and Gynecologists - 2005
A practice bulletin on urinary incontinence from the American College of Obstetricians and Gynecologists (2005) considered sacral nerve neuromodulation to be beneficial for treating chronic voiding dysfunction. An updated 2015 practice bulletin on urinary incontinence from the College did not address sacral nerve stimulation (SNS).
Fecal Disorders
National Institute for Health and Care Excellence - 2007
The National Institute for Health and Care Excellence (2007) issued guidance on the management of fecal incontinence. The guidance was reviewed in 2014, and no changes were made. The guidance has recommended:
- 'A trial of temporary sacral nerve stimulation should be considered for people with fecal incontinence in whom sphincter surgery is deemed inappropriate
- All individuals should be informed of the potential benefits and limitations of this procedure and should undergo a trial stimulation period of at least 2 weeks to determine if they are likely to benefit.
- People with fecal incontinence should be offered sacral nerve stimulation on the basis of their response to percutaneous nerve evaluation during specialist assessment, which is predictive of therapy success.'
American College of Gastroenterology - 2014
In its clinical guideline on the management of benign anorectal disorders, including fecal incontinence, the American College of Gastroenterology (2014) found that 'sacral nerve stimulation should be considered in [fecal incontinence] who do not respond to conservative therapy.'
