SUFU20: Point-Counterpoint: Neuromodulation: Where Should We Place the Lead?

SUFU podcast

Moderator: Cristiano Gomes, MDSacral is the TargetSpeaker: Steven W. Siegel, MDOther TargetsSpeaker: Scott A. MacDiarmid, MDJust think of the number of patients we see each and every day with overactive bladder and who do not reach their treatment goal inspite of us trying a number of medications and behavioral interventions. And to make the problem worse, the penetrance of our thirdline therapies in patients with refractory OAB (ROAB) is less than 5%.Dr. Siegel will highlight the benefits of sacral nerve stimulation for the management of this difficult population of patients. I will shine thelight on neuromodulation directed towards ‘other targets’ concentrating on the tibial and saphenous nerve.I will briefly remind us of the excellent efficacy and safety of percutaneous tibial nerve stimulation (PTNS) advancing us one step closerto neuromodulation for the masses. I will introduce a subcutaneously implanted coin-sized tibial nerve stimulator (eCoin), an excitingnew office-based implant currently under investigation. Transcutaneous electrical stimulation of the saphenous nerve will also be noted.Our goal is to highlight therapies and to energize the audience in pursuing excellence in the management of the overactive bladderpatient. Steve plays tennis, I’m hockey. Not a fair fight but welcome to our program. Cheers.