Sacral nerve root stimulation for the treatment of urge incontinence and detrusor dysfunction utilizing a cephalocaudal intraspinal method of lead insertion:: A case report

Sacral nerve root stimulation (SNRS) is known to be effective in the treatment of pelvic motor dysfunction(1-4). Bladder and urethral motor disorders commonly treated include urinary urge incontinence, voiding/detrusor dysfunction, and urgency/frequency syndromes. To date, neurostimulation specific to bladder and urethral dysfunction has applied a unilateral, trans-sacral approach. (Interstim, Medtronic, Minneapolis, MN) Despite some success, this method has been associated with technical failures in maintaining electrode position(5,6). As an alternative, this case report describes the selective epidural application of a cephalocaudal ("retrograde") lead insertion method in a patient with severe detrusor dysfunction and urinary urge incontinence(7).