Peripheral Neuromodulation

Neuromodulation of the lower urinary tract is commonly utilized in patients with overactive bladder. This chapter describes the history, clinical practice and development of peripheral neuromodulation systems, in tibial nerve stimulation, pudendal nerve stimulation and dorsal genital nerve stimulation. Percutaneous tibial nerve stimulation is minimally invasive but, in its current iteration, is time-consuming for the patient and requires in-office treatment. New implantable tibial nerve stimulation devices are in development, which may allow improved comfort combined with home use and may contribute to improved compliance with long-term therapy. Pudendal nerve and dorsal genital nerve stimulation have demonstrated some initial promising data in relieving over active bladder in several small series but are less far along in development.