Programming Algorithms for Sacral Neuromodulation: Clinical Practice and Evidence—Recommendations for Day-to-Day Practice

Lehur PA, Sørensen M, Dudding TC, Knowles CH, de Wachter S, Engelberg S, Matzel KE (2020)

Publication Type: Journal article, Review article

Publication year: 2020

Journal

Neuromodulation Wiley-Blackwell

DOI: 10.1111/ner.13117

Abstract

Background: In sacral neuromodulation (SNM), stimulation programming plays a key role to achieve success of the therapy. However to date, little attention has been given to the best ways to set and optimize SNM programming during the test and chronic stimulation phases of the procedure. Objective: Standardize and make SNM programming easier and more efficient for the several conditions for which SNM is proposed. Methods: Systematic literature review and collective clinical experience report. Results: The basic principles of SNM programming are described. It covers choice of electrode configuration, stimulation amplitude, pulse frequency and pulse widths, while use of cycling is also briefly discussed. Step-by-step practical flow charts developed by a group of 13 European experts are presented. Conclusions: Programming of SNM therapy is not complex. There are few programming settings that seem beneficial or significantly impact patient outcomes. Only four basic electrode configurations could be identified according to four different options to define the cathode. In a majority of patients, the proposed stimulation parameters will allow a satisfactory improvement for long periods of time. A regular follow-up is, however, necessary to assess and eventually optimize results, as well as to reassure patients.

Involved external institutions

Hospital Network Antwerp / Ziekenhuis Netwerk Antwerpen (ZNA) BE Belgium (BE) Medtronic International Trading Sàrl CH Switzerland (CH) Hvidovre Hospital DK Denmark (DK) Ospedale Regionale di Lugano - Civico e Italiano CH Switzerland (CH) Queen Mary University of London GB United Kingdom (GB) University Hospital Southampton NHS GB United Kingdom (GB)

How to cite

APA:

Lehur, P.A., Sørensen, M., Dudding, T.C., Knowles, C.H., de Wachter, S., Engelberg, S., & Matzel, K.E. (2020). Programming Algorithms for Sacral Neuromodulation: Clinical Practice and Evidence—Recommendations for Day-to-Day Practice. Neuromodulation. https://dx.doi.org/10.1111/ner.13117

MLA:

Lehur, Paul A., et al. "Programming Algorithms for Sacral Neuromodulation: Clinical Practice and Evidence—Recommendations for Day-to-Day Practice." Neuromodulation (2020).

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