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Sacral nerve stimulation

S Haas, C Brock, K Krogh, M Gram, L Lundby, A M Drewes, S Laurberg
BACKGROUND: It has been suggested that the effects of sacral nerve stimulation against fecal incontinence involve neuromodulation at spinal or supraspinal levels. OBJECTIVE: This study aims to investigate the afferent sensory pathways from the anorectum before and during sacral nerve stimulation. DESIGN: This is an explorative study. PATIENTS: Fifteen women with idiopathic fecal incontinence (mean age, 58 ± 12.2 years) were selected...
November 2016: Diseases of the Colon and Rectum
Elena Esra Foditsch, Reinhold Zimmermann
PURPOSE: The aim of this study was to develop a controlled approach for sacral neuromodulation (SNM) to improve both nerve targeting and tined lead placement, for which a new computed tomography (CT)-guided implantation technique was analyzed in minipigs. MATERIALS AND METHODS: This study included five female, adult Göttingen minipigs. In deep sedoanalgesia, the minipigs were placed in an extended prone position. Commercially available SNM materials were used (needle, introduction sheath, and quadripolar tined lead electrode)...
2016: Research and Reports in Urology
Y G Zhang, W J Shao, Y F Gu, J F Qiu, L Yuan, G D Li
Sacral nerve stimulation (SNS) is an alternative surgical approach to alleviate fecal incontinence and constipation. This study aimed to explore the effects and underlying mechanisms of SNS with acupuncture on gut transit time and colon c-kit protein expression in rats with slow transit constipation (STC). Fifty Sprague-Dawley rats were randomly divided into five groups: blank control, SNS, Mosapride, sham SNS, and STC model control group. The STC model was established by subcutaneous injection of morphine...
September 23, 2016: Genetics and Molecular Research: GMR
Mai Banakhar, Magdy Hassouna
PURPOSE: InterStim device is an U.S. Food and Drug Administration approved minimal invasive therapy for sacral neuromodulation for lower urinary tract dysfunction. Before InterStim implantation, a trial with the appropriate screening tests is required to determine patient therapy eligibility. There are two different techniques for patient screening: percutaneous nerve evaluation (PNE) test and staged test. Few studies have reported success and failure rates for each technique. However, test sensitivity and predictive values of either test have not been studied...
September 2016: International Neurourology Journal
Teng Maëlys, Gilberte Robain, Samy Bendaya
OBJECTIVE: Sacral neuromodulation is usually used to treat non-obstructive urinary retention when other forms of treatment have failed. An improvement greater than 50% in urinary symptoms after 40months of follow-up has been shown: - moreover, it also has few complications: infections, technical failures, discomfort; - we report a case of dystonia of the lower limb, appeared after sacral neuromodulation implantation. OBSERVATIONS: MMP is a 16-year-old boy with early puberty as noteworthy medical history...
September 2016: Annals of Physical and Rehabilitation Medicine
Ahmed S El-Azab, Steven W Siegel
The field of Sacral Neuromodulation is continually evolving and still in its infancy. Common dilemmas experienced with this therapy will be discussed in this article, including ways to avoid and manage them. The focus will be on test evaluations performed with either peripheral nerve evaluation (PNE) or staged procedure, the clinical effectiveness and safety of unilateral versus bilateral test stimulation for both the PNE and staged procedures, and best methods to determine the success of the trial phase. We will also discuss how to deal with the problem of declining efficacy of the device over time...
November 2016: Current Urology Reports
Fabio G Rodrigues, Sami A Chadi, Alejandro J Cracco, Dana R Sands, Massarat Zutshi, Brooke Gurland, Giovanna Da Silva, Steven D Wexner
AIM: Sphincteroplasty (SP) is used to treat faecal incontinence (FI) in patients with a sphincter defect. Sacral nerve stimulation (SNS) is now the form of interventional treatment used in most patients, but in those with a sphincter defect its outcome has not been definitively evaluated. We compared the results of SP and SNS for FI associated with a sphincter defect. METHOD: Patients treated by SNS or SP for FI with an associated sphincter defect were retrospectively identified from an IRB-approved prospective database...
September 12, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Jakob Duelund-Jakobsen, Lilli Lundby, Paul-Antoine Lehur, Vincent Wyart, Søren Laurberg, Steen Buntzen
: Sacral nerve stimulation (SNS) is effective for faecal incontinence (FI). Little is known about the relationship between the implantation technique and the functional outcome. AIM: The study aimed to explore the relationship between the numbers of active electrode poles (AEP) used during permanent lead placement and subsequent function, therapeutic amplitude and the need for extra appointments between scheduled follow-up visits. METHOD: 186 patients with FI who underwent permanent implantation between May-2009 and March-2015 with a tined (barbed) lead (3093/3080-Medtronic) using the straight stylet were registered on the European two-centre SNS prospective database (SNSPD)...
September 13, 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Teresa C Rice, Yarini Quezada, Janice F Rafferty, Ian M Paquette
BACKGROUND: Sacral neuromodulation using a 2-staged approach is an established therapy for fecal incontinence. Office-based percutaneous nerve evaluation is a less-invasive alternative to the stage 1 procedure but is seldom used in the evaluation of patients with fecal incontinence. OBJECTIVE: The aim of this study was to determine the clinical success of percutaneous nerve evaluation versus a staged approach. DESIGN: This was a retrospective review of a prospectively maintained, single-institution database of patients treated with sacral neuromodulation for fecal incontinence...
October 2016: Diseases of the Colon and Rectum
Peter L Lu, Carlo Di Lorenzo
PURPOSE OF REVIEW: The use of neurostimulation for treatment of gastrointestinal disorders has been growing over the past two to three decades. Our objective is to review current applications of neurostimulation in the treatment of gastrointestinal disorders with an emphasis on the use of these treatment modalities in children. RECENT FINDINGS: Gastric electrical stimulation can lead to symptomatic improvement in children with chronic nausea and vomiting refractory to conventional treatment, and a recent report of long-term outcomes is encouraging...
October 2016: Current Opinion in Pediatrics
Katarzyna Bochenska, Anne-Marie Boller
Fecal incontinence (FI) is a chronic and debilitating condition that carries a significant health, economic, and social burden. FI has a considerable psychosocial and financial impact on patients and their families. A variety of treatment modalities are available for FI including behavioral and dietary modifications, pharmacotherapy, pelvic floor physical therapy, bulking agents, anal sphincteroplasty, sacral nerve stimulation, artificial sphincters, magnetic sphincters, posterior anal sling, and colostomy.
September 2016: Clinics in Colon and Rectal Surgery
Michael David Fejka
Fecal incontinence affects patients of all sexes, races, and ethnicities; however, those affected often are afraid or too embarrassed to ask for help. Attention to risk factors and directed physical examinations can help healthcare providers diagnose and formulate treatment plans. Numerous diagnostic tests are available. Diligent follow-up is needed to direct patients to second-line therapies such as sacral nerve stimulation or surgical procedures.
September 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
Thomas Frieling
Fecal incontinence is defined by the unintentional loss of solid or liquid stool, and anal incontinence includes leakage of gas and / or fecal incontinence. Anal-fecal incontinence is not a diagnosis but a symptom. Many patients hide the problem from their families, friends, and even their doctors. Epidemiologic studies indicate a prevalence between 7-15 %, up to 30 % in hospitals and up to 70 % in longterm care settings. Anal-fecal incontinence causes a significant socio-economic burden. There is no widely accepted approach for classifying anal-fecal incontinence available...
August 2016: Deutsche Medizinische Wochenschrift
S Haas, D Liao, H Gregersen, L Lundby, S Laurberg, K Krogh
BACKGROUND: Sacral nerve stimulation (SNS) is a well-established treatment for fecal incontinence but its mode of action remains obscure. Anal sphincter function is usually evaluated with manometry but resistance to distension may be a more appropriate parameter than luminal pressure. The functional lumen imaging probe allows detailed description of distension properties of the anal canal. Our objective in this study was to characterize the impact of SNS on distension properties of the anal canal in patients with idiopathic fecal incontinence...
August 21, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
Vicki Patton, Peter Stewart, David Z Lubowski, Ian J Cook, Phil G Dinning
BACKGROUND: Sacral nerve stimulation is proposed as a treatment for slow-transit constipation. However, in our randomized controlled trial we found no therapeutic benefit over sham stimulation. These patients have now been followed-up over a long-term period. OBJECTIVE: The purpose of this study was to assess the long-term efficacy of sacral nerve stimulation in patients with scintigraphically confirmed slow-transit constipation. DESIGN: This study was designed for long-term follow-up of patients after completion of a randomized controlled trial...
September 2016: Diseases of the Colon and Rectum
John S Thornton
PURPOSE: This review summarises the need for MRI with in situ neuromodulation, the key safety challenges and how they may be mitigated, and surveys the current status of MRI safety for the main categories of neuro-stimulation device, including deep brain stimulation, vagus nerve stimulation, sacral neuromodulation, spinal cord stimulation systems, and cochlear implants. REVIEW SUMMARY: When neuro-stimulator systems are introduced into the MRI environment a number of hazards arise with potential for patient harm, in particular the risk of thermal injury due to MRI-induced heating...
June 20, 2016: European Journal of Paediatric Neurology: EJPN
J Castillo, L Cristóbal, J Alonso, R Martín, D Suárez, M A Martínez, C Cagigas, M Gómez-Ruiz, M Gómez-Fleitas, A Vázquez-Barquero
AIM: Sacral nerve stimulation (SNS) lead implantation is a straightforward procedure for individuals with intact spinal vertebrae. When sacral anomalies are present, however, the anatomical and radiological reference points used for the accurate placement of the electrode may be absent or difficult to identify. METHOD: We describe an innovative surgical procedure of percutaneous nerve evaluation for SNS in a patient with faecal incontinence secondary to a congenital imperforate anus and partial sacral agenesis using a surgical imaging platform (O-arm system) under neurophysiological control...
September 2016: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
Dong Cheng, Lei Hu, Feng Xian, Jian Zhong, Yuejuan Zhang, Gangwei Wang, Jiyuan Ma, Hao Xu
OBJECTIVE: To observe the clinical effects of needle-pricking therapy, a newly medical and minimally invasive technique, for functional retrograde ejaculation and to explore its mechanism. Methods Thirty-six patients with functional retrograde ejaculation were randomly divided into an observation group(19 cases) and a control group(17 cases) In the observation group,needle-pricking therapy was used at Guanyuan(CV 4) and bilateral sacral plexus nerve,lumbar 1 nerve and greater occipital nerve stimulating points,once a week...
February 2016: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
Anne J Wright, Mirna Haddad
Both non-invasive and invasive electroneurostimulation (ENS) modalities for bladder bowel dysfunction have been studied and reported in children. A summary of the proposed mechanism of actions and the more commonly used and recently reported techniques and outcomes are described. This includes transcutaneous electrical nerve stimulation, functional electrical nerve stimulation, intravesical electrical nerve stimulation, percutaneous tibial nerve stimulation and sacral neuromodulation in conditions including overactive bladder, enuresis, dysfunctional voiding, constipation, combined bladder bowel dysfunction and neuropathic bladder and bowel dysfunction...
May 27, 2016: European Journal of Paediatric Neurology: EJPN
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