Editing CUA: Neurogenic Lower Urinary Tract Dysfunction (2019) (section)

=== Neural stimulation and neuromodulation therapy ===
* '''Current data supporting the use of sacral neuromodulation (SNM) and peripheral tibial nerve stimulation (PTNS) are limited'''; remains unclear which subgroups of neurogenic voiding dysfunction and which underlying neurological disease will respond best to these different therapies.
*# '''SNM could be considered for the treatment of NDO or non-obstructive urinary retention in carefully selected individuals with NLUTD, as it can be a safe and effective option'''. It should be preceded by an adequate testing phase and may not be a good alternative to decrease detrusor pressures or improve bladder compliance.
*# '''PTNS can be effective in NLUTD resulting from MS, but requires initial frequent weekly visits.''' PTNS appears to be well-tolerated and effective in small studies, with minimal reported adverse events, mainly mild to moderate pain at the puncture site
* '''Dorsal rhizotomy (sacral deafferentation S2-S4/5) and sacral anterior root stimulation by an implantable device can achieve safe storage detrusor pressure and voluntary emptying of bladder and bowel in patients with complete SCI.''' '''Furthermore, it diminishes autonomic dysreflexia.''' This technique has good variable success rates in specialized centres, but comes with long-term complications and a very high rate of surgical revisions