Pudendal Neuromodulation

Pudendal neuromodulation is an outpatient procedure where a tiny electrode is placed at the pudendal nerve in the pelvis that branches the second, third and fourth sacral nerves. An electrical pulse generator similar to a heart pacemaker connected to the electrode is implanted in the patient's upper buttock. The device emits a low level pulse that stimulates the pudendal nerve sending signals to the brain to override abnormal signals causing pelvic pain, urinary and bowel issues in those with a condition called pudendal neuropathy.

Neuromodulation is believed to work by affecting central processing in the brain and correcting signals being sent through the nerves to the pelvic organs, which is what leads to the underlying complications and symptoms of pelvic pain and urinary or bowel issues.

Patients typically undergo two procedures during the treatment process. The first involves placing electrodes at the pudendal nerve that connect to electrical pulse generators worn outside the body. This allows the patient to "test drive" the treatment for two weeks, measuring its impact on symptoms. If the patient sees significant improvement, they will undergo a second procedure, which is permanent implantation of the electrical pulse generators.

Although not a cure, the procedure is successful about 85 percent of the time in achieving at least a 50 percent improvement in symptoms. Some get an 80 to 90 percent improvement.

The procedure was pioneered by Beaumont urologist Kenneth Peters, M.D. He and his colleagues at Beaumont's Women's Urology Center have performed the procedure on about 200 patients, more than anyone else in the world. Dr. Peters' research on pudendal neuromodulation has been published in a number of urology journals.