Sacral nerve stimulation is more efficient in facilitating pelvic floor responses than pudendal nerve stimulation

Sacral neuromodulation in nine human participants requires lower current than pudendal nerve stimulation to elicit maximum urethra pressure changes (p = 0.01).

• Why it matters: It is unclear how stimulating sacral versus pudendal nerve targets differentially recruits pelvic floor activity, limiting mechanistic understanding of these off-label and third-line therapies.
• What they did: During SNM lead implant surgery, intra-operative sacral nerve stimulation was paired with EAS electromyography and multi-segment urethra pressure recordings, then compared with previously collected PNS-evoked responses.
• The result: Maximum urethra pressure change per mA was higher with SNS than PNS (p = 0.005), implying SNS achieves greater urethra recruitment efficiency per unit current in this human sample.

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