**5.1 Neuromodulation**

An attempt is made to modulate the nerve reflexes that control the bladder, sphincter and the pelvic floor through sacral nerve stimulation. The use of this technique is well documented in certain neurologically affected patients; however, in patients with myelomeningocele, there are controversial results due to structural abnormalities found at a sacral level, which makes this technique a lot harder. Evidence is still limited; however, this remains a continuous field of investigation (**Figure 4**) [20].
