• Mirko Bakula, Dinko Hauptman, Tvrtko Hudolin, Sandra Nađ Škegro, Katarina Ivana Tudor, Branko Bakula, and Željko Kaštelan.
• Department of Urology, Zagreb University Hospital Center, Zagreb, Croatia.
• Acta Clin Croat. 2023 Jul 1; 62 (Suppl2): 143147143-147.

AbstractSacral neuromodulation (SNM) is a safe, efficacious, and minimally invasive advanced therapy that involves electrical stimulation to sacral nerve root to modulate neural pathway. Indications for SNM include symptoms of overactive bladder (OAB), urinary incontinence, urinary retention, urgency and frequency and, regarding bowel dysfunction, fecal incontinence . In Europe and Canada, indication is also established for chronic constipation. The mechanism of action is still not fully elucidated and complete understanding is yet to be determined. It is proposed that SNM modulates neural circuits in both central and peripheral pathways, thus having an impact on the brain, as well as on the bladder-targeting neuronal activity. Another possible significant effect on irregular bladder activity is through inhibition of the bladder afferent pathways by stimulation of the pudendal nerve. Over the past two decades, with more than 300 000 treated patients, SNM has confirmed its efficacy to relieve refractory OAB symptoms, as well as urinary retention or fecal incontinence. First SNM applications in Croatia were uneventful and we are glad to offer our patients this novel therapy in the future.Sestre Milosrdnice University Hospital.

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