The role of electrodiagnostic techniques in the reprogramming of patients with a delayed suboptimal response to sacral nerve stimulation

Sacral neuromodulation is an approved therapy for frequency, urgency, urge incontinence and non-obstructive urinary retention. There are several recent reports on a subgroup of patients who are 'Iate failures' to therapy. This descriptive study aimed to determine whether the use of electrodiagnosis during reprogramming could provide objective data on device function in these patients and help direct therapy. We employed electrodiagnostic techniques to differentiate between those patients who could be reprogrammed in the office to a site of maximal response, those that required reoperation, and those in whom reoperation was unlikely to be successful. Our findings suggest that electrodiagnostic monitoring may help to direct future therapy in this group of patients who currently present a management challenge.