A difficult aspect of this study is how success should be defined, given that there is a constellation of symptoms associated with neurogenic bladder and bowel. Does the benefit of the procedure outweigh the inherent risks, particularly to the lower extremity? Is success defined as eliciting a detrusor contraction with stimulation of the dermatome? If this is the definition of success, then this surgery clearly works for the majority of patients. In addition, a number of patients have noticed a change in their voiding and bowel function, with several reporting improvements including increased sensation of the bowel and bladder, new ability to initiate voiding, improved bowel function, less detrusor overactivity and the ability to stop antimuscarinics. Are these changes enough to define success? Our clinical success at 12 months is less than the 85% previously reported.7 However, these are interim data and may change with time.