Genital Nerve Stimulation (GNS) – A Game-Changer in Gynecology
By Prof. Marc Possover, MD, PhD - Founder and CEO NeuroGyn AGTherapeutic Void in Gynecology
The Therapeutic Void in Gynecology – and Why NeuroGyn Was Born to Fill It
While gynecology has advanced in many areas, pelvic nerve stimulation remains surprisingly overlooked. Yet it holds great promise for treating overactive bladder, pelvic pain, and sexual dysfunction with precision. Yes, therapies such as Botox®, Sacral Nerve Modulation (SNM), and Posterior Tibial Nerve Stimulation (PTNS) exist and are effective. But let’s be honest – they exist everywhere but in gynecology.
It is a silent scandal: millions of women suffer from urgency, incontinence, and pelvic pain, yet their gynecologists – their first and often only trusted medical contact – have no tools beyond outdated medications and behavioral advice. And when those fail, which they frequently do, there is… nothing. No neuromodulation. No advanced options. Just frustration, embarrassment, and suffering.
Why? Because the entire system – medical device companies, insurance systems, academic societies – has quietly overlooked the fact that these therapies are simply not available to gynecologists. Gynecologists are not trained to perform SNM. They don’t have access to cystoscopic Botox procedures. Tibial stimulation devices don’t fit into their clinical workflow. Insurance won’t reimburse the follow-ups. And patients who are referred to neuro-urologists are often lost to another specialty forever.
The result? The illusion of treatment options. Yes, these therapies exist on paper – but not in gynecological practice. And that’s where women go. That’s where they turn for help. And that’s where they’re too often met with a therapeutic dead end.
So when someone asks, “Why another method like GNS?” the answer is simple: because in gynecology, there is no method. GNS (Genital Nerve Stimulation) isn’t just “another option.” It is the only one designed by a gynecologist, for gynecologists, using techniques they already know—minimally invasive, familiar, and safe. No spinal access. No lead migration. No trial phase. No need for programming technicians. Just elegant simplicity and powerful results.
This is why NeuroGyn exists.
Not as a competitor in a saturated market, but as the first and only company in the world focused entirely on neuromodulation for gynecology—as its name says:
NeuroGyn – Neuromodulation in Gynecology.
It is a revolution long overdue. And it starts now
Why Stimulation of the Dorsal Nerve of the Clitoris (GNS) is Superior to Pudendal, Sacral, or Tibial Nerve Stimulation
Overactive Bladder (OAB), pelvic pain, fecal incontinence, and sexual dysfunction are widespread disorders that affect millions of women globally, yet gynecologists still lack an effective, safe, and practical tool to treat them.
While neuromodulation therapies such as Sacral Nerve Modulation (SNM), Pudendal Nerve Stimulation (PNS), and Posterior Tibial Nerve Stimulation (PTNS) have shown benefit, they all share significant limitations that make them unsuitable for integration into gynecological practice.
1. Superior Control of Overactive Bladder (OAB)
Stimulation of the Dorsal Nerve of the Clitoris (DNC) provides more direct and effective modulation of bladder function compared to sacral, pudendal, or tibial nerve stimulation. The DNC carries afferent fibers that are directly involved in the reflex arcs controlling detrusor muscle activity and urinary continence. Unlike sacral or tibial approaches that rely on indirect or distant stimulation, the DNC is a peripheral, superficial, and accessible
nerve that allows for targeted neuromodulation of bladder reflexes without involving the spinal cord or sacral roots. This precise targeting leads to faster therapeutic response, lower risk of side effects, and greater efficacy in controlling urgency, frequency, and incontinence symptoms. In clinical and anatomical studies, stimulation of the
DNC has demonstrated superior symptom relief in patients with idiopathic OAB, especially in those who failed other neuromodulation therapies.
2. Simultaneous Control of Intestinal Disorders
The DNC is part of a broader network of autonomic and somatic fibers that communicate with the pelvic plexus.
Through antidromic low-frequency stimulation, DNC activation can influence not only bladder but also intestinal motility and sphincter control.
Unlike the pudendal nerve, which is deeply located and primarily affects the anal sphincter, or the tibial nerve, which is only indirectly connected to pelvic organs, stimulation of the DNC achieves broader modulation of the pelvic autonomic nervous system. This results in improved control of fecal urgency and incontinence, as well as normalization of irregular bowel function, especially in patients with mixed pelvic floor disorders.
3. Restoration of Sexual Function (DNC + Cavernous Nerves Stimulation)
The DNC is the primary sensory nerve of the clitoris, while the cavernous nerves, which lie in close proximity, are responsible for vascular and erectile function. GNS (Genital Nerve Stimulation) targets both these nerves simultaneously through a double-down retropubic approach, allowing for combined sensory and autonomic stimulation.
This dual stimulation enhances genital arousal, improves blood flow, and restores orgasmic function—benefits that sacral or tibial stimulation cannot offer, as those nerves do not influence the cavernous nerves directly.
While pudendal stimulation can partially support sexual function, the deep anatomical course and higher risk of lead migration limit its long-term success.
In contrast, GNS with targeted stimulation of the DNC and cavernous nerves is uniquely capable of restoring both sensory and autonomic aspects of sexual health, offering a comprehensive solution for women suffering from anorgasmia, reduced arousal, or genital pain.
Naturally, these anatomical advantages also applies to men, making GNS the first pelvic neuromodulation technique for the treatment of male erectile dysfunction.
In summary, stimulation of the Dorsal Nerve of the Clitoris provides a more effective, focused, and comprehensive neuromodulation approach for pelvic disorders—uniquely addressing urinary, intestinal, and sexual symptoms through a minimally invasive, gynecologist-friendly technique.
Why GNS is the Logical and Safer Evolution of the TVT Procedure – and the Future of Gynecology
The GNS procedure is directly inspired by the retropubic TVT (tension-free vaginal tape) technique – one of the most widely performed and understood procedures in gynecology. Like TVT, GNS uses a percutaneous retropubic approach, but instead of implanting a mesh under the urethra, it places a stimulation electrode behind the pubic bone and then advances it forward into direct contact with the DNC.
This familiarity in technique means that any gynecologist trained in urogynecology or vaginal surgery can easily adopt the GNS approach without needing fluoroscopy, spinal access, or specialized equipment. In fact, the entire procedure can be performed in a simple outpatient setting using tools already present in most gynecological practices.
Yet, unlike TVT, GNS avoids the risks of mesh-related complications: no urethral injuries, no erosion, no chronic pain syndromes. It provides a reversible, adjustable, and non-destructive alternative that does not damage tissue, but instead activates natural nerve reflexes to restore pelvic function. The risk of a retropubic hematoma is significantly lower than with the TVT procedure as well, as the introduction of the applicator in the
GNS procedure is placed considerably more laterally below the pubic bone around 2cm laterally to the urethra and therefore remains far from the Santorini plexus.
The passage of the electrode cable beneath and then behind the pubic bone protects it from any external trauma and, naturally, from migration—since we do not sit on the genital organs nor on the pubic symphysis.
The permanent connection between the electrode and the PosStim neurostimulator eliminates the risk of lead dislocation, significantly shortens the operative time—since no connection is required during implantation—and reduces the amount of surgical material needed for such a connection (e.g., screws or connectors).
Furthermore, the implantable device used in GNS – PosStim – is uniquely designed for a retropubic implantation.Compact, rechargeable, and completely hidden behind the pubic bone, it allows discreet use and easy recharging during daily life. It eliminates the visibility and lifestyle restrictions of sacral or tibial implants, empowering patients to live without stigma or limitation.
For gynecologists, GNS fills a long-standing therapeutic void. It allows them to finally address OAB, sexual dysfunction, and pelvic pain with a method developed specifically for their field, by one of their own. With a rapidly growing patient demand, and no comparable solution currently available, GNS is not just the best method
– it is the method gynecology has been waiting for.
For more innovations in gynecology, visit our article on GNS for overactive bladder.
For more information
Don’t hesitate to contact the POSSOVER Medical Center in Zurich if you have some
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