Neuromodulation Round Table: Past, Present and Future
The term neuromodulation was coined as a pharmacological term and is defined as the physiological process by which a given neurone uses several different neurotransmitters to regulate diverse populations of central nervous system neurones. In recent years this term has been applied to the use of electrical stimulation to influence neural processes and to thereby treat lower urinary tract dysfunction. In his review of the “past”, Dr. Chris Chapple will consider the pharmacological therapies, as well as the previous work on the use of transcutaneous, percutaneous and direct stimulation therapy of nerves to influence lower urinary tract dysfunction and review the development of contemporary therapy with reference to the proposed mechanisms and the lessons learned to date which have led on to current and potential future therapeutic options. On the following lecture, Dr. Philip Van Kerrebroeck will review the evidence of the most studied and currently used forms of neuromodulation for the lower urinary tract – percutaneous tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS) – analysing short, medium and long term results, as well as strategies for optimizing outomes. Finally, Dr. Michele Spinelli will explore the futures perspectives on new neuromodulation targets, including the pudendal nerve, and future technologies.