Which statement describes sacral nerve stimulation incontinence management?

• A. A device implanted in the bladder to increase storage capacity
• B. A neuromodulation therapy that modulates sacral nerve pathways to reduce detrusor overactivity and improve continence in refractory cases
• C. A pelvic floor exercise program
• D. A medication that relaxes the detrusor

Answer: (B)

Sacral nerve stimulation is a neuromodulation approach that targets the sacral nerves, usually via an implanted generator and lead that stimulate the S3 (and nearby) nerve pathways. By delivering controlled electrical pulses, it modulates the neural signals that control the bladder’s storage and voiding reflexes. This modulation reduces involuntary detrusor contractions (detrusor overactivity), increases bladder capacity, and thereby improves continence. It’s specifically used in patients with urinary incontinence who have not achieved satisfactory control with conservative measures or medications, making it a durable option for refractory cases. The other options describe different strategies—placing a device directly in the bladder, pelvic floor exercises, or a medication that relaxes the detrusor—which do not achieve the same neuromodulatory effect on sacral neural pathways.