Abstract Introduction: At times, sacral neuromodulation may fail primarily or secondarily to treat overactive symptoms or nonobstructive urinary retention. Can pudendal neuromodulation be utilized to treat these patients with continued success with either disease entity? Materials and Methods: Between February 2014 and 2016, 14 patients underwent pudendal neuromodulation placement after failed stage 2 sacral neuromodulation without lead migration and could not control their symptoms as well as before. All underwent unilateral right-sided pudendal stage 1 neuromodulation for at least a 2-week trial with weekly follow-ups of their voiding diaries and straight catheterization of postvoiding residual urines. Results: Eighty-six percent of patients [12/14] had a 50% improvement with a 50% reduction of frequency, urgency, and nocturia [9/9]. Whereas 3/5 in urinary retention were able to void with a postvoid straight catheterization of <50 mL. Two patients both less than 50 years of age with diabetic cystopathy ...