Sacral neuromodulation (SNM), also known as sacral nerve stimulation (SNS), is a minimally invasive therapeutic technique, which delivers short-pulse electrical currents to specific sacral nerves (S2-S4) by implanting a long-term electrical stimulation device, to modulate urologic and bowel dysfunction. In recent years, SNM has demonstrated significant efficacy in refractory urologic and bowel dysfunctions. Its minimally invasive, safe and durable advantages offer a novel therapeutic option for patients. This article systematically reviews the mechanisms, technical procedures, clinical applications, advantages and limitations, and recent research advances of SNM, so as to provide reference for the research and clinical translation of SNM in urologic and intestinal dysfunction diseases.

1.Black CJ, Drossman DA, Talley NJ, et al. Functional gastrointestinal disorders: advances in understanding and management[J]. Lancet, 2020, 396(10263): 1664-1674. DOI: 10.1016/S0140-6736(20)32115-2.

2.Quaghebeur J, Petros P, Wyndaele JJ, et al. Pelvic-floor function, dysfunction, and treatment[J]. Eur J Obstet Gynecol Reprod Biol, 2021, 265: 143-149. DOI: 10.1016/j.ejogrb.2021.08.026.

3.Tian XT, Zhan JP, Qiao C, et al. Rising of natural therapies: potential and challenges of traditional Chinese medicine in the management of gastrointestinal diseases[J]. World J Gastroenterol, 2025, 31(9): 103145. DOI: 10.3748/wjg.v31.i9.103145.

4.Feloney MP, Stauss K, Leslie SW. Sacral Neuromodulation[M]. Treasure Island (FL): StatPearls [Internet], 2024. https://www.ncbi.nlm.nih.gov/books/NBK567751/

5.Noblett KL, Buono K. Sacral nerve stimulation as a therapy for patients with refractory voiding and bowel dysfunction[J]. Obstet Gynecol, 2018, 132(6): 1337-1345. DOI: 10.1097/AOG.0000000000002968.

6.De Wachter S, Vaganee D, Kessler TM. Sacral neuromodulation: mechanism of action[J]. Eur Urol Focus, 2020, 6(5): 823-825. DOI: 10.1016/j.euf.2019.11.018.

7.徐智慧. 骶神经调控在盆底功能障碍相关下尿路疾病中的应用[J]. 中国医师杂志, 2019, 21(5): 654-657. [Xu ZH. Application of sacral neuromodulation in lower urinary tract diseases related to pelvic floor dysfunction[J]. Journal of Chinese Physician, 2019, 21(5): 654-657.] DOI: 10.3760/cma.j.issn.1008- 1372.2019.05.004.

8.Cui Z, Wang Z, Ye G, et al. A novel three-dimensional printed guiding device for electrode implantation of sacral neuromodulation[J]. Colorectal Dis, 2018, 20(1): 26-29. DOI: 10.1111/codi.13958.

9.Assmann R, Douven P, Kleijnen J, et al. Stimulation parameters for sacral neuromodulation on lower urinary tract and bowel dysfunction-related clinical outcome: a systematic review[J]. Neuromodulation, 2020, 23(8): 1082-1093. DOI: 10.1111/ner.13255.

10.秦川, 郝钢跃. 骶神经调节在难治性膀胱过度活动症治疗中的思考和展望[J]. 国际外科学杂志, 2023, 50(7): 442-446. [Qin C, Hao GY. Reflections and perspectives on sacral neuromodulation in the treatment of refractory overactive bladder disorder[J]. International Journal of Surgery, 2023, 50(7): 442-446.] DOI: 10.3760/cma.j.cn115396-20230531-00154.

11.Schmidt RA, Jonas U, Oleson KA, et al. Sacral nerve stimulation for treatment of refractory urinary urge incontinence[J]. J Urol, 1999, 162(2): 352-357. https://pubmed.ncbi.nlm.nih.gov/10411037/

12.Gormley EA, Lightner DJ, Burgio KL, et al. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline[J]. J Urol, 2012, 188(6 Suppl): 2455-2463. DOI: 10.1016/j.juro.2012.09.079.

13.Groenendijk IM, Groen J, Scheepe JR, et al. Acute effect of sacral neuromodulation for treatment of detrusor overactivity on urodynamic parameters[J]. Neurourol Urodyn, 2020, 39(2): 695-701. DOI: 10.1002/nau.24252.

14.Kaaki B, Gupta D. Medium-term outcomes of sacral neuromodulation in patients with refractory overactive bladder: a retrospective single-institution study[J]. PLoS One, 2020, 15(7): e0235961. DOI: 10.1371/journal.pone.0235961.

15.Liu P, Li Y, Shi B, et al. Comparison of different types of therapy for overactive bladder: a systematic review and network meta-analysis[J]. Front Med (Lausanne), 2022, 9: 1014291. DOI: 10.3389/fmed.2022.1014291.

16.Stoffel JT, Peterson AC, Sandhu JS, et al. AUA white paper on nonneurogenic chronic urinary retention: consensus definition, treatment algorithm, and outcome end points[J]. J Urol, 2017, 198(1): 153-160. DOI: 10.1016/j.juro.2017.01.075.

17.Chan G, Qu LG, Gani J. Evaluation of pre-operative bladder contractility as a predictor of improved response rate to a staged trial of sacral neuromodulation in patients with detrusor underactivity[J]. World J Urol, 2021, 39(6): 2113-2119. DOI: 10.1007/s00345-020-03380-z.

18.Cardarelli S, D'Elia C, Cerruto M A, et al. Efficacy of sacral neuromodulation on urological diseases: a multicentric research project[J]. Urologia, 2012, 79(2): 90-96. DOI: 10.5301/RU.2012.9278.

19.Saber-Khalaf M, Abtahi B, Gonzales G, et al. Sacral neuromodulation outcomes in male patients with chronic urinary retention[J]. Neuromodulation, 2015, 18(4): 329-334. DOI: 10.1111/ner.12268.

20.Bakrim N, Chabannes É, Detree P, et al. Sacral neuromodulation as treatment of non-neurological vesical emptying disorders[J]. Prog Urol, 2022, 32(1): 14-22. DOI: 10.1016/j.purol.2021.06.004.

21.马雪霞, 樊帆, 黄海. 全程管理在神经源性膀胱患者骶神经调节治疗的疗效评价[J]. 中华腔镜泌尿外科杂志（电子版）, 2022, 16(1): 35-39. [Ma XX, Fan F, Huang H. Evaluation of the effect of full-course management on sacral neuromodulation in patients with neurogenic bladder[J]. Chinese Journal of Endourology (Electronic Edition), 2022, 16(1): 35-39.] DOI: 10.3877/cma.j.issn.1674-3253.2022.01.008.

22.Jergova S, Hentall ID, Gajavelli S, et al. Intraspinal transplantation of GABAergic neural progenitors attenuates neuropathic pain in rats: a pharmacologic and neurophysiological evaluation[J]. Exp Neurol, 2012, 234(1): 39-49. DOI: 10.1016/j.expneurol.2011.12.005.

23.Kessler TM, La Framboise D, Trelle S, et al. Sacral neuromodulation for neurogenic lower urinary tract dysfunction: systematic review and Meta-analysis[J]. Eur Urol, 2010, 58(6): 865-874. DOI: 10.1016/j.eururo.2010.09.024.

24.Van Ophoven A, Engelberg S, Lilley H, et al. Systematic literature review and Meta-analysis of sacral neuromodulation (SNM) in patients with neurogenic lower urinary tract dysfunction (nLUTD): over 20 years' experience and future directions[J]. Adv Ther, 2021, 38(4): 1987-2006. DOI: 10.1007/s12325-021-01650-9.

25.Lombardi G, Del Popolo G. Clinical outcome of sacral neuromodulation in incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms[J]. Spinal Cord, 2009, 47(6): 486-491. DOI: 10.1038/sc.2008.172.

26.陈沛贤, 黄浩, 贺情情, 等. 基于尿动力学结果的二阶聚类分析在神经源性膀胱患者骶神经调控术二期转化中的预测价值[J]. 中华泌尿外科杂志, 2024, 45(9): 686-692. [Chen PX, Huang H, He QQ, et al. Predictive value of two-step clustering analysis based on urodynamics for efficacy of sacral neuromodulation in patients with neurogenic bladder[J]. Chinese Journal of Urology, 2024, 45(9): 686-692.] DOI: 10.3760/cma.j.cn112330-20240819-00373.

27.Homma Y, Akiyama Y, Tomoe H, et al. Clinical guidelines for interstitial cystitis/bladder pain syndrome[J]. Int J Urol, 2020, 27(7): 578-589. DOI: 10.1111/iju.14234.

28.Homma Y, Ueda T, Tomoe H, et al. Clinical guidelines for interstitial cystitis and hypersensitive bladder updated in 2015[J]. Int J Urol, 2016, 23(7): 542-549. DOI: 10.1111/iju.13118.

29.Malde S, Palmisani S, Al-Kaisy A, et al. Guideline of guidelines: bladder pain syndrome[J]. BJU Int, 2018, 122(5): 729-743. DOI: 10.1111/bju.14399.

30.张翼飞, 詹长生, 尹水平, 等. 骶神经调节术治疗间质性膀胱炎/膀胱疼痛综合征的临床疗效[J]. 中华泌尿外科杂志, 2024, 45(2): 118-121. [Zhang YF, Zhan CS, Yin SP, et al. Clinical application of sacral nerve modulation in the treatment of interstitial cystitis/bladder pain syndrome[J]. Chinese Journal of Urology, 2024, 45(2): 118-121.] DOI: 10.3760/cma.j.cn112330-20210427-00230.

31.Hernández-Hernández D, Padilla-Fernández B, Navarro-Galmés MÁ, et al. Sacral neuromodulation in the management of bladder pain syndrome/interstitial cystitis[J]. Current Bladder Dysfunction Reports, 2020, 15: 83-92. DOI: 10.1007/s11884-020-00579-z.

32.Xiang H, Zhang T, Al-Danakh A, et al. Neuromodulation in chronic pelvic pain: a narrative review[J]. Pain Ther, 2022, 11(3): 789-816. DOI: 10.1007/s40122-022-00405-w.

33.Yu WR, Jhang JF, Jiang YH, et al. The pathomechanism and current treatments for chronic interstitial cystitis and bladder pain syndrome[J]. Biomedicines, 2024, 12(9). DOI: 10.3390/biomedicines12092051.

34.Rekatsina M, Leoni MLG, Visser-Vandewalle V, et al. Long-term outcomes of sacral neuromodulation for refractory interstitial cystitis/bladder pain syndrome: a retrospective cohort study[J]. J Clin Med, 2025, 14(11): 3647. DOI: 10.3390/jcm14113647.

35.Assmann SL, Keszthelyi D, Kleijnen J, et al. Guideline for the diagnosis and treatment of faecal incontinence-a UEG/ESCP/ESNM/ESPCG collaboration[J]. United European Gastroenterol J, 2022, 10(3): 251-286. DOI: 10.1002/ueg2.12213.

36.Mellgren A, Wexner SD, Coller JA, et al. Long-term efficacy and safety of sacral nerve stimulation for fecal incontinence[J]. Dis Colon Rectum, 2011, 54(9): 1065-1075. DOI: 10.1097/DCR.0b013e31822155e9.

37.Hull T, Giese C, Wexner SD, et al. Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence[J]. Dis Colon Rectum, 2013, 56(2): 234-245. DOI: 10.1097/DCR.0b013e318276b24c.

38.De Meyere C, Nuytens F, Parmentier I, et al. Five-year single center experience of sacral neuromodulation for isolated fecal incontinence or fecal incontinence combined with low anterior resection syndrome[J]. Tech Coloproctol, 2020, 24(9): 947-958. DOI: 10.1007/s10151-020-02245-2.

39.Roy AL, Gourcerol G, Menard JF, et al. Predictive factors for successful sacral nerve stimulation in the treatment of fecal incontinence: lessons from a comprehensive treatment assessment[J]. Dis Colon Rectum, 2014, 57(6): 772-780. DOI: 10.1097/DCR.0000000000000115.

40.Kirss J JR, Pinta T, Rautio T, et al. Impact of sphincter lesions and delayed sphincter repair on sacral neuromodulation treatment outcomes for faecal incontinence: results from a Finnish national cohort study[J]. Int J Colorectal Dis, 2018, 33(12): 1709-1714. DOI: 10.1007/s00384-018-3161-0.

41.Rydningen M, Dehli T, Wilsgaard T, et al. Sacral neuromodulation compared with injection of bulking agents for faecal incontinence following obstetric anal sphincter injury-a randomized controlled trial[J]. Colorectal Dis, 2017, 19(5): 134-144. DOI: 10.1111/codi.13632.

42.Barbara G, Barbaro MR, Marasco G, et al. Chronic constipation: from pathophysiology to management[J]. Minerva Gastroenterol (Torino), 2023, 69(2): 277-290. DOI: 10.23736/S2724-5985.22.03335-6.

43.Maeda Y, O'Connell PR, Lehur PA, et al. Sacral nerve stimulation for faecal incontinence and constipation: a European consensus statement[J]. Colorectal Dis, 2015, 17(4): 74-87. DOI: 10.1111/codi.12905.

44.Kamm MA, Dudding TC, Melenhorst J, et al. Sacral nerve stimulation for intractable constipation[J]. Gut, 2010, 59(3): 333-340. DOI: 10.1136/gut.2009.187989.

45.Huang Z, Li S, Foreman RD, et al. Sacral nerve stimulation with appropriate parameters improves constipation in rats by enhancing colon motility mediated via the autonomic-cholinergic mechanisms[J]. Am J Physiol Gastrointest Liver Physiol, 2019, 317(5): 609-617. DOI: 10.1152/ajpgi.00150.2018.

46.Zerbib F, Siproudhis L, Lehur PA, et al. Randomized clinical trial of sacral nerve stimulation for refractory constipation[J]. Br J Surg, 2017, 104(3): 205-213. DOI: 10.1002/bjs.10326.

47.Patton V, Stewart P, Lubowski DZ, et al. Sacral nerve stimulation fails to offer long-term benefit in patients with slow-transit constipation[J]. Dis Colon Rectum, 2016, 59(9): 878-885. DOI: 10.1097/DCR.0000000000000653.

48.Wang J, Shen Z, Shen B, et al. Defecation induced by stimulation of sacral S2 spinal root in cats[J]. Am J Physiol Gastrointest Liver Physiol, 2021, 321(6): 735-742. DOI: 10.1152/ajpgi.00269.2021.

49.Guan Q. A comprehensive review and update on the pathogenesis of inflammatory bowel disease[J]. J Immunol Res, 2019: 7247238. DOI: 10.1155/2019/7247238.

50.Rogler G, Singh A, Kavanaugh A, et al. Extraintestinal manifestations of inflammatory bowel disease: current concepts, treatment, and implications for disease management[J]. Gastroenterology, 2021, 161(4): 1118-1132. DOI: 10.1053/j.gastro.2021.07.042.

51.Payne SC, Furness JB, Burns O, et al. Anti-inflammatory effects of abdominal vagus nerve stimulation on experimental intestinal inflammation[J]. Front Neurosci, 2019, 13: 418. DOI: 10.3389/fnins.2019.00418.

52.Guo J, Jin H, Shi Z, et al. Sacral nerve stimulation improves colonic inflammation mediated by autonomic-inflammatory cytokine mechanism in rats[J]. Neurogastroenterol Motil, 2019, 31(10): e13676. DOI: 10.1111/nmo.13676.

53.Willemze RA, Welting O, Van Hamersveld HP, et al. Neuronal control of experimental colitis occurs via sympathetic intestinal innervation[J]. Neurogastroenterol Motil, 2018, 30(3). DOI: 10.1111/nmo.13163.

54.Chen Z, Li J, Ma Q, et al. Anti-inflammatory effects of two-week sacral nerve stimulation therapy in patients with ulcerative colitis[J]. Neuromodulation, 2024, 27(2): 360-371. DOI: 10.1016/j.neurom.2023.01.019.

55.Drissi F, Bourreille A, Neunlist M, et al. Sacral neuromodulation for refractory ulcerative colitis: safety and efficacy in a prospective observational series of eight patients[J]. Tech Coloproctol, 2023, 27(6): 501-505. DOI: 10.1007/s10151-023-02793-3.

56.Pikov V. Vagus nerve stimulation and sacral nerve stimulation for inflammatory bowel disease: a systematic review[J]. J Transl Gastroenterol, 2023, 1(2): 94-100. DOI: 10.14218/jtg.2023.00098.

57.Tu L, Gharibani P, Yin J, et al. Sacral nerve stimulation ameliorates colonic barrier functions in a rodent model of colitis[J]. Neurogastroenterol Motil, 2020, 32(10): e13916. DOI: 10.1111/nmo.13916.

58.Jin X, Gharibani P, Yin J, et al. Neuro-immune modulation effects of sacral nerve stimulation for visceral hypersensitivity in rats[J]. Front Neurosci, 2021, 15: 645393. DOI: 10.3389/fnins.2021.645393.

59.中华医学会泌尿外科学分会尿控学组. 骶神经调控术临床应用中国专家共识（第三版）[J]. 中华泌尿外科杂志, 2024, 45(9): 649-653. [Group of Urinary Control, Urology Branch of Chinese Medical Association. Chinese expert consensus on the clinical application of sacral neuromodulation (third edition)[J]. Chinese Journal of Urology, 2024, 45(9): 649-653.] DOI: 10.3760/cma.j.cn112330-20240920-00417.

60.Meng L, Yan Z, Wang X, et al. Preliminary analysis of stimulation parameters for sacral neuromodulation in different indications: a multicenter retrospective cohort study from China[J]. Int J Surg, 2024, 110(6): 3536-3542. DOI: 10.1097/JS9.0000000000001302.

61.Jing J, Meng L, Zhang Y, et al. Remote programming in stage I sacral neuromodulation: a multicentre prospective feasibility study[J]. Int J Surg, 2024, 110(4): 2104-2114. DOI: 10.1097/JS9.0000000000001140.

62.王继鹏, 闫泽浩, 张炯, 等. 盆底功能障碍性疾病骶神经调控术治疗进展[J]. 中国现代神经疾病杂志, 2025, 25(1): 78-83. [Wang JP, Yan ZH, Zhang J, et al. Progress on sacral neuromodulation in treatment of pelvic floor dysfunction[J]. Chinese Journal of Contemporary Neurology and Neurosurgery, 2025, 25(1): 78-83.] DOI: 10.3969/j.issn.1672-6731.2025. 01.011.

63.余燕岚, 周子越, 莫斯斯, 等. 骶神经调控术在难治性神经源性下尿路功能障碍患者中的参数设置研究[J]. 临床泌尿外科杂志, 2025, 40(8): 715-719. [Yu YL, Zhou ZY, Mo SS, et al. Research on parameter settings of sacral neuromodulation in patients with refractory neurogenic lower urinary tract dysfunction[J]. Journal of Clinical Urology, 2025, 40(8): 715-719.] DOI: 10.13201/j.issn.1001-1420.2025.08.009.

64.Werneburg GT, Werneburg EA, Goldman HB, et al. Machine learning provides an accurate prognostication model for refractory overactive bladder treatment response and is noninferior to human experts[J]. Neurourol Urodyn, 2022, 41(3): 813-819. DOI: 10.1002/nau.24881.