{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:28:38Z","timestamp":1790371718921,"version":"4.1.0"},"reference-count":66,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,10,25]],"date-time":"2020-10-25T00:00:00Z","timestamp":1603584000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100004374","name":"Medtronic","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004374","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Colorectal Disease"],"published-print":{"date-parts":[[2021,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Sacral neuromodulation (SNM) is a widely adopted treatment for overactive bladder, non\u2010obstructive urinary retention and faecal incontinence. In the majority, it provides sustained clinical benefit. However, it is recognized that, even for these patients, stimulation parameters (such as amplitude, electrode configuration, frequency and pulse width) may vary at both initial device programming and at reprogramming, the latter often being required to optimize effectiveness. Although some recommendations exist for SNM programming, the scientific data to support them are understood by few clinicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a narrative review of the literature covering some of the science behind stimulating a mixed peripheral nerve and available preclinical data in the field of SNM. It covers electrode configuration, amplitude, frequency, pulse width and cycling considerations. The review is targeted at clinicians with an interest in the field and does not seek to provide exhaustive detail on basic neuroscience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results and conclusions<\/jats:title><jats:p>Knowledge of the science of neuromodulation provides some guiding principles for programming but these are broad. These principles are not refuted by preclinical data but specific parameters in clinical use are not strongly supported by animal data, even after the limitations of small and large animal models are considered. The review presents a shortlist of programming principles on a theoretical basis but acknowledges that current practice is as much derived from evolved experience as science.<\/jats:p><\/jats:sec>","DOI":"10.1111\/codi.15390","type":"journal-article","created":{"date-parts":[[2020,10,3]],"date-time":"2020-10-03T13:23:29Z","timestamp":1601731409000},"page":"592-602","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["The science behind programming algorithms for sacral neuromodulation"],"prefix":"10.1111","volume":"23","author":[{"given":"Charles H.","family":"Knowles","sequence":"first","affiliation":[{"name":"Centre for Neuroscience Surgery and Trauma Blizard Institute Queen Mary University of London and Barts Health NHS Trust London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"de Wachter","sequence":"additional","affiliation":[{"name":"Department of Urology Faculty of Health Sciences University Hospital Antwerpen University Antwerpen Antwerp Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Engelberg","sequence":"additional","affiliation":[{"name":"Medtronic Intl Sarl Tolochenaz Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Lehur","sequence":"additional","affiliation":[{"name":"Coloproctology Unit Ospedale Regionale di Lugano Lugano Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus E.","family":"Matzel","sequence":"additional","affiliation":[{"name":"Chirurgische Klinik Universit\u00e4t Erlangen Erlangen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lance","family":"Zirpel","sequence":"additional","affiliation":[{"name":"Global Neuromodulation Research Medtronic Inc Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the European SNM Expert Group","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,10,25]]},"reference":[{"key":"e_1_2_15_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2017.07.010"},{"key":"e_1_2_15_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12696"},{"key":"e_1_2_15_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-410X.2007.07282.x"},{"key":"e_1_2_15_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2007.08.034"},{"key":"e_1_2_15_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/DCR.0b013e318276b24c"},{"key":"e_1_2_15_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9740"},{"key":"e_1_2_15_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2011.02.2694"},{"key":"e_1_2_15_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9226"},{"key":"e_1_2_15_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181cf8ed0"},{"key":"e_1_2_15_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)15999-0"},{"key":"e_1_2_15_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934-011-0204-2"},{"key":"e_1_2_15_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00192-017-3496-z"},{"key":"e_1_2_15_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11934\u2010018\u20100837\u20105"},{"issue":"1","key":"e_1_2_15_15_1","first-page":"21","article-title":"Sacral nerve neuromodulation (InterStim). 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