Sacral neuromodulation is indicated in urgency frequency, urge incontinence, mixed incontinence with a significant urge component, and unobstructed urinary retention. More recently, it is indicated for interstitial cystitis. The work-up includes a complete history and physical examination, urinalysis, urine culture, cytology, and voiding diary. Cystoscopy, urodynamics, and upper tract imaging are performed as indicated. These diagnostics serve three purposes: 1) to identify an underlying disorder that should be treated by other means (calculus or carcinoma in situ), 2) to clarify the etiology of the lower urinary tract dysfunction, and 3) to serve as a baseline for later comparison.
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