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Sacral nerve stimulation

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https://www.readbyqxmd.com/read/27920880/conditional-electrical-stimulation-in-animal-and-human-models-for-neurogenic-bladder-working-toward-a-neuroprosthesis
#1
C R Powell
Sacral neuromodulation has had a tremendous impact on the treatment of urinary incontinence and lower urinary tract symptoms for patients with neurologic conditions. This stimulation does not use real-time data from the body or input from the patient. Incorporating this is the goal of those pursuing a neuroprosthesis to enhance bladder function for these patients. Investigators have demonstrated the effectiveness of conditional (also called closed-loop) feedback in animal models as well as limited human studies...
December 2016: Current Bladder Dysfunction Reports
https://www.readbyqxmd.com/read/27887683/sacral-nerve-stimulation-allows-for-decreased-antegrade-continence-enema-use-in-children-with-severe-constipation
#2
Peter L Lu, Lindsey Asti, Daniel L Lodwick, Kristine M Nacion, Katherine J Deans, Peter C Minneci, Steven Teich, Seth A Alpert, Desale Yacob, Carlo Di Lorenzo, Hayat M Mousa
BACKGROUND: Sacral nerve stimulation (SNS) can be beneficial for children with constipation, but no studies have focused on children with constipation severe enough to require antegrade continence enemas (ACEs). Our objective was to evaluate the efficacy of SNS in children with constipation treated with ACE. METHODS: Using a prospective patient registry, we identified patients <21years old who were receiving ACE prior to SNS placement. We compared ACE/laxative usage, PedsQL Gastrointestinal Symptom Scale (GSS), Fecal Incontinence Quality of Life Scale (FIQL), Fecal Incontinence Severity Index (FISI), and Vancouver Dysfunctional Elimination Syndrome Score (DES) at baseline and progressive follow-up time intervals...
November 10, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27868230/no-immediate-effect-on-urodynamic-parameters-during-transcutaneous-electrical-nerve-stimulation-tens-in-children-with-overactive-bladder-and-daytime-incontinence-a-randomized-double-blind-placebo-controlled-study
#3
Luise Borch, Soeren Rittig, Konstantinos Kamperis, Birgitte Mahler, Jens Christian Djurhuus, Soeren Hagstroem
AIM: To evaluate the immediate effect on natural fill urodynamic parameters and bladder function during transcutaneous electrical nerve stimulation (TENS) in children with overactive bladder (OAB) and daytime urinary incontinence (DUI). METHODS: In this double-blind, placebo-controlled study, 24 children with severe OAB and DUI (mean age 8.5 ± 1.2 years) underwent 48-h natural fill urodynamics. After 24 h of baseline investigation, the children were randomized to either active continuous TENS (n = 12) or placebo TENS (n = 12) over the sacral S2-S3 outflow...
November 21, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27844258/surface-anatomical-landmarks-for-the-location-of-posterior-sacral-foramina-in-sacral-nerve-stimulation
#4
A Povo, M Arantes, K E Matzel, J Barbosa, M A Ferreira, D Pais, A Rodríguez-Baeza
BACKGROUND: Sacral nerve stimulation is a common treatment for various pelvic floor disorders. It consists of the percutaneous introduction of electrodes through the posterior sacral foramina for therapeutic stimulation of the target sacral spinal nerve. The aim of our study was to determine the surface anatomical landmarks of the sacrum to facilitate identification of the posterior sacral foramina. METHODS: This study was conducted on 20 human cadavers. The cadavers were placed in a prone position, and all the soft tissues of the sacral region were removed to allow exposure of the osseous structures...
November 14, 2016: Techniques in Coloproctology
https://www.readbyqxmd.com/read/27836361/ultrasound-guided-intrasphincteric-botulinum-toxin-injection-relieves-obstructive-defecation-due-to-hirschsprung-s-disease-and-internal-anal-sphincter-achalasia
#5
Joseph T Church, Samir K Gadepalli, Toghrul Talishinsky, Daniel H Teitelbaum, Marcus D Jarboe
PURPOSE: Chronic obstructive defecation can occur in patients with Hirschsprung Disease (HD) and internal anal sphincter (IAS) achalasia. Injection of Botulinum Toxin (BoTox) into the IAS can temporarily relieve obstructive defecation, but can be challenging when performed by tactile sense alone. We compared results of BoTox injections with and without ultrasound (US) guidance. METHODS: We retrospectively reviewed BoTox injections into the IAS for obstructive defecation over 5years...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27816462/-lower-urinary-tract-dysfunction-in-normal-pressure-hydrocephalus-review-of-the-literature
#6
E Bey, B Nicot, O Casez, L Le Normand
INTRODUCTION: Lower urinary tract dysfunction in normal pressure hydrocephalus has received little attention from the scientific community. The aim of this review article was to discuss diagnostic and therapeutic options for these patients. SOURCES: A literature review of MedLine publications on urinary incontinence in normal pressure hydrocephalus was conducted. The following keywords were used: "hydrocephalus, normal pressure" and "bladder dysfunction" or "urinary incontinence" or "overactive bladder" or "urinary bladder, neurogenic"...
December 2016: Progrès en Urologie
https://www.readbyqxmd.com/read/27788509/experimental-electrophysiological-and-pressure-responses-of-urinary-bladder-detrusor-to-lumbar-to-sacral-nerve-rerouting-an-animal-study-with-negative-results
#7
Pavel Zerhau, Zdeněk Mackerle, Matej Husár, Daniela Sochůrková, Eva Brichtová, Eduard Gopfert, Martin Faldyna, Martin Kubát, Ladislav Plánka
: Background/Aims/Objectives: To verify the transfer of evoked potentials through anastomosis of an experimentally created micturition reflex arc and to detect said potentials directly on the detrusor and sphincter of rabbit urinary bladder. METHODS: During 2013-2015, 17 rabbits were operated upon and measurement followed during reoperation 3-16 months later. Suitable ventral spinal roots were electrophysiologically detected following laminectomy, and a somatic-central nervous system-autonomic micturition reflex arc was created...
2016: Urologia Internationalis
https://www.readbyqxmd.com/read/27779312/randomized-clinical-trial-of-sacral-nerve-stimulation-for-refractory-constipation
#8
F Zerbib, L Siproudhis, P-A Lehur, C Germain, F Mion, A-M Leroi, B Coffin, A Le Sidaner, V Vitton, C Bouyssou-Cellier, G Chene
BACKGROUND: Open studies have reported favourable results for sacral nerve stimulation in the treatment of refractory constipation. Here, its efficacy was assessed in a double-blind crossover RCT. METHODS: Patients with at least two of the following criteria were included: fewer than three bowel movements per week; straining to evacuate on more than 25 per cent of attempts; or sensation of incomplete evacuation on more than 25 per cent of occasions. Response to therapy was defined as at least three bowel movements per week and/or more than 50 per cent improvement in symptoms...
October 25, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27749479/does-sacral-nerve-stimulation-improve-continence-through-enhanced-sensitivity-of-the-anal-canal-a-pilot-study
#9
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
https://www.readbyqxmd.com/read/27730097/development-of-a-ct-guided-standard-approach-for-tined-lead-implantation-at-the-sacral-nerve-root-s3-in-minipigs-for-chronic-neuromodulation
#10
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
https://www.readbyqxmd.com/read/27706768/effects-of-sacral-nerve-stimulation-with-acupuncture-on-gut-transit-time-and-c-kit-expression-in-colon-of-rats-with-slow-transit-constipation
#11
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
https://www.readbyqxmd.com/read/27706006/percutaneous-nerve-evaluation-test-versus-staged-test-trials-for-sacral-neuromodulation-sensitivity-specificity-and-predictive-values-of-each-technique
#12
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
https://www.readbyqxmd.com/read/27676716/dystonia-of-the-lower-limb-after-sacral-neuromodulation-implanted-to-a-16-year-old-boy-with-non-obstructive-chronic-urinary-retention
#13
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
https://www.readbyqxmd.com/read/27629495/specific-tips-for-general-controversies-in-sacral-neuromodulation
#14
REVIEW
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
https://www.readbyqxmd.com/read/27620162/faecal-incontinence-in-patients-with-a-sphincter-defect-comparison-of-sphincteroplasty-and-sacral-nerve-stimulation
#15
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
https://www.readbyqxmd.com/read/27619970/is-the-efficacy-of-sacral-nerve-stimulation-for-faecal-incontinence-dependent-on-the-number-of-active-electrode-poles-achieved-during-permanent-lead-insertion
#16
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
https://www.readbyqxmd.com/read/27602927/dynamic-article-percutaneous-nerve-evaluation-versus-staged-sacral-nerve-stimulation-for-fecal-incontinence
#17
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
https://www.readbyqxmd.com/read/27583411/neurostimulation-of-the-gastrointestinal-tract-in-children-is-it-time-to-shock-the-gut
#18
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
https://www.readbyqxmd.com/read/27582653/fecal-incontinence-epidemiology-impact-and-treatment
#19
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
https://www.readbyqxmd.com/read/27580000/fecal-incontinence-a-review-of-current-treatment-options
#20
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
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