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Sacral nerve stimulation

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https://www.readbyqxmd.com/read/28931549/sacral-neuromodulation-blocks-pudendal-inhibition-of-reflex-bladder-activity-in-cats-insight-into-the-efficacy-of-sacral-neuromodulation-in-fowler-s-syndrome
#1
Xing Li, Jamie Uy, Michelle Yu, Shun Li, Katherine Theisen, Jeffrey Browning, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
This study tested the hypothesis that sacral neuromodulation, i.e. electrical stimulation of afferent axons in sacral spinal root, can block pudendal afferent inhibition of the micturition reflex. In α-chloralose anesthetized cats, pudendal nerve stimulation (PNS) at 3-5 Hz was used to inhibit bladder reflex activity while the sacral S1 or S2 dorsal root was stimulated at 15-30 Hz to mimic sacral neuromodulation and to block the bladder inhibition induced by PNS. The intensity threshold (T) for PNS or S1/S2 dorsal root stimulation (DRS) to induce muscle twitch of anal sphincter or toe was determined...
September 20, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28885782/evaluation-of-pulse-width-of-spinal-nerve-stimulation-in-a-rat-model-of-bladder-micturition-reflex
#2
Xin Su, Heather A Simenson, David A Dinsmoor, Heather D Orser
OBJECTIVES: The spinal nerve stimulation (SNS) evoked motor threshold (Tmot ) response across different pulse-widths (PWs) was first explored and a subset of selected stimulation PWs were further assessed with respect to bladder reflex contraction (BRC). MATERIALS AND METHODS: In anesthetized female rats, wire electrodes were placed under each of the L6 spinal nerves to produce bilateral SNS. The relationship of Tmot response with PW was analyzed using a monoexponential nonlinear regression...
September 8, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28877395/optimal-lead-positioning-in-sacral-neuromodulation-which-factors-are-related-to-treatment-outcome
#3
Ranjana Jairam, Tom Marcelissen, Gommert van Koeveringe, Philip van Kerrebroeck
OBJECTIVES: Sacral neuromodulation (SNM) is a well-established treatment for overactive bladder (OAB) and non-obstructive urinary retention (NOR). During test stimulation, the lead is positioned along the third sacral nerve, which ideally results in a response in all four contact points (active electrodes). However, it is unclear whether the position of the lead (depth, angle, deflection) and the number of active electrodes is related to the outcome of SNM. METHODS: All patients who underwent test stimulation using the tined lead between January 2011 and September 2016 were included in this retrospective study...
September 6, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28838787/surgical-interventions-and-the-use-of-device-aided-therapy-for-the-treatment-of-fecal-incontinence-and-defecatory-disorders
#4
Adil E Bharucha, Satish S C Rao, Andrea Shin
DESCRIPTION: The purpose of this clinical practice update expert review is to describe the key principles in the use of surgical interventions and device-aided therapy for managing fecal incontinence (FI) and defecatory disorders. METHODS: The best practices outlined in this review are based on relevant publications, including systematic reviews and expert opinion (when applicable). BEST PRACTICE ADVICE 1: A stepwise approach should be followed for management of FI...
August 21, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28832311/surgical-technique-for-removal-of-tined-lead-for-interstim
#5
Zhamshid Okhunov, Bilal Farhan, Ahmed Ahmed, Christopher Pulford, Gamal Ghoniem
INTRODUCTION: We aimed to introduce our technique describing the removal of a chronic implanted tined-lead in patients with a sacral neuromodulator implant. MATERIALS AND METHODS: We performed a retrospective review of patients who had chronic sacral neuromodulator (InterStim) implanted by a single surgeon from 2001 through 2015. This simple surgical technique was developed and successfully performed to remove the leads. Primary reasons for removal were elective due to poor symptoms control and failure to maintain response or lead migration...
August 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28799195/sacral-nerve-stimulation-for-constipation-and-fecal-incontinence-in-children-long-term-outcomes-patient-benefit-and-parent-satisfaction
#6
P L Lu, I J N Koppen, D K Orsagh-Yentis, K Leonhart, E J Ambeba, K J Deans, P C Minneci, S Teich, K A Diefenbach, S A Alpert, M A Benninga, D Yacob, C Di Lorenzo
OBJECTIVE: To evaluate the long-term efficacy of sacral nerve stimulation (SNS) in children with constipation and describe patient benefit and parent satisfaction. METHODS: Using a prospective patient registry, we identified patients <21 years old with constipation treated with SNS for >2 years. We compared symptoms, medical treatment, PedsQL Gastrointestinal Symptom Scale (GSS), Fecal Incontinence Quality of Life Scale (FIQL), and Fecal Incontinence Severity Index (FISI) before SNS and at follow-up...
August 10, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28731583/the-effectiveness-of-transcutaneous-tibial-nerve-stimulation-ttns-for-adults-with-overactive-bladder-syndrome-a-systematic-review
#7
REVIEW
Joanne Booth, Lesley Connelly, Sylvia Dickson, Fiona Duncan, Maggie Lawrence
AIMS: To evaluate effectiveness of transcutaneous tibial nerve stimulation (TTNS) for treating adults with overactive bladder (OAB) of idiopathic or neurogenic origin, using a systematic review of the literature. METHODS: Systematic searches of four databases were undertaken between 1980 and 2017. Included studies investigated effects of TTNS on OAB. Study selection, data extraction, quality appraisal was performed by two independent reviewers. Narrative analysis was undertaken where meta-analysis was not possible due to study heterogeneity...
July 21, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28729224/robotic-placement-of-fenix-continence-restoration-system-in-a-patient-with-previous-radiation-to-the-pelvis-a-case-report
#8
Mariana Espinal, Christopher C DeStephano, Paulami Guha, Shilpa P Gajarawala, Anita H Chen, Paul D Pettit
Fecal incontinence (FI) is a disabling problem affecting women. Conservative treatment includes dietary modification, antimotility agents, and pelvic floor physical therapy. If conservative medical management is unsuccessful, surgical intervention may be required. Surgical options include rectal sphincteroplasty, bulking agent injection, radiofrequency anal sphincter remodeling procedure and sacral nerve stimulation (SNS) therapy. Recently, a new therapy for FI, the FENIX Continence Restoration System has become available...
July 17, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28718163/incidence-and-management-of-lower-urinary-tract-symptoms-after-urethral-stricture-repair
#9
REVIEW
Amanda S J Chung, Kurt A McCammon
Lower urinary tract symptoms (LUTS) after urethral stricture repair are not uncommon. Urgency has been reported in 40% of men and urge incontinence in 12% of men after anterior urethroplasty. De novo urgency and urge incontinence is seen in 9 and 5% of men, respectively, after urethroplasty. Once a complication of urethroplasty (such as recurrent urethral stricture or diverticulum) has been excluded as a cause, evaluation of LUTS in such patients should focus on differentiating bladder dysfunction (overactive bladder, underactive bladder), from other outlet obstruction (such as benign prostatic obstruction), dysfunctional voiding, or medical causes (such as nocturnal polyuria)...
September 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28682126/a-method-for-securing-the-temporary-lead-s-in-sacral-nerve-stimulation
#10
P M Smith, C Tawadros, N Fletcher, C D Betts
No abstract text is available yet for this article.
July 6, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28681496/transcutaneous-sacral-nerve-stimulation-for-intraoperative-verification-of-internal-anal-sphincter-innervation
#11
D W Kauff, T Moszkowski, C Wegner, A Heimann, K-P Hoffmann, T B Krüger, H Lang, W Kneist
BACKGROUND: The current standard for pelvic intraoperative neuromonitoring (pIONM) is based on intermittent direct nerve stimulation. This study investigated the potential use of transcutaneous sacral nerve stimulation for non-invasive verification of pelvic autonomic nerves. METHODS: A consecutive series of six pigs underwent low anterior rectal resection. For transcutaneous sacral nerve stimulation, an array of ten electrodes (cathodes) was placed over the sacral foramina (S2 to S4)...
July 6, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/28673064/effects-of-acute-sacral-neuromodulation-at-different-frequencies-on-bladder-overactivity-in-pigs
#12
Xing Li, Limin Liao, Guoqing Chen, Zhaoxia Wang, Han Deng
PURPOSE: We investigated the effects of different stimulation frequencies on the inhibition of bladder overactivity by sacral neuromodulation (SNM) in pigs. METHODS: Implant-driven stimulators were used to stimulate the S3 spinal nerve in 13 pigs. Cystometry was performed by infusing normal saline (NS) or acetic acid (AA). SNM (pulse width, 210 µsec) at frequencies ranging from 5 to 50 Hz was conducted at the intensity threshold at which observable perianal and/or tail movement was induced...
June 2017: International Neurourology Journal
https://www.readbyqxmd.com/read/28656519/where-are-we-headed-with-neuromodulation-for-overactive-bladder
#13
REVIEW
Kaitlin Jaqua, Charles R Powell
Overactive bladder (OAB) affects millions of people around the world and decreases quality of life for those affected. Over the past two decades, significant advances in treatment have transformed the lives of those with OAB. Sacral neuromodulation (SNM), posterior tibial nerve stimulation (PTNS), and dorsal genital nerve stimulation are the most effective contemporary treatment modalities. New techniques and bio-sensing schemes offer promise to advance therapy beyond what is currently available. Current neuromodulation techniques do not use real-time data from the body or input from the patient...
August 2017: Current Urology Reports
https://www.readbyqxmd.com/read/28615976/clinical-utility-of-neurostimulation-devices-in-the-treatment-of-overactive-bladder-current-perspectives
#14
REVIEW
Dick Aw Janssen, Frank Mj Martens, Liesbeth L de Wall, Hendrikje Mk van Breda, John Pfa Heesakkers
OBJECTIVES: This review describes the evidence from established and experimental therapies that use electrical nerve stimulation to treat lower urinary tract dysfunction. METHODS: Clinical studies on established treatments such as percutaneous posterior tibial nerve stimulation (P-PTNS), transcutaneous electrical nerve stimulation (TENS), sacral nerve stimulation (SNS) and sacral anterior root stimulation (SARS) are evaluated. In addition, clinical evidence from experimental therapies such as dorsal genital nerve (DGN) stimulation, pudendal nerve stimulation, magnetic nerve stimulation and ankle implants for tibial nerve stimulation are evaluated...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28615244/stimulation-of-the-pelvic-nerve-increases-bladder-capacity-in-the-prostaglandin-e2-rat-model-of-overactive-bladder
#15
Christopher L Langdale, James A Hokanson, Arun Sridhar, Warren M Grill
Overactive bladder (OAB) syndrome is a highly prevalent condition that may lead to medical complications and decreased quality of life. Emerging therapies focusing on selective electrical stimulation of peripheral nerves associated with lower urinary tract (LUT) function may provide improved efficacy and reduced side effects compared to sacral neuromodulation for the treatment of OAB symptoms. Prior studies investigating the effects of pelvic nerve (PelN) stimulation on LUT function were focused on promoting bladder contractions, and it is unclear if selective stimulation of the PelN would be beneficial for the treatment of OAB...
June 14, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28504930/extracorporeal-stimulation-of-sacral-nerve-roots-for-observation-of-pelvic-autonomic-nerve-integrity-description-of-a-novel-methodological-setup
#16
Tomasz Moszkowski, Daniel Kauff, Celine Wegner, Roman Ruff, Karin Somerlik-Fuchs, Thilo Krueger, Piotr Augustyniak, Klaus-Peter Hoffmann, Werner Kneist
INTRODUCTION: Neurophysiologic monitoring can improve autonomic nerve sparing during critical phases of rectal cancer surgery. OBJECTIVES: To develop a system for extracorporeal stimulation of sacral nerve roots. METHODS: Dedicated software controlled a ten-electrode stimulation array by switching between different electrode configurations and current levels. A built-in impedance and current level measurement assessed the effectiveness of current injection...
May 12, 2017: IEEE Transactions on Bio-medical Engineering
https://www.readbyqxmd.com/read/28477435/sacral-nerve-stimulation-can-be-an-effective-treatment-for-low-anterior-resection-syndrome
#17
Saleh M Eftaiha, Banujan Balachandran, Slawomir J Marecik, Anders Mellgren, Johan Nordenstam, George Melich, Leela M Prasad, John J Park
AIM: Sacral nerve stimulation has become a preferred method for the treatment of faecal incontinence in patients who fail conservative (non-operative) therapy. In previous small studies, sacral nerve stimulation has demonstrated improvement of faecal incontinence and quality of life in a majority of patients with low anterior resection syndrome. We evaluated the efficacy of sacral nerve stimulation in the treatment of low anterior resection syndrome, using a recently developed and validated low anterior resection syndrome instrument to quantify symptoms...
May 6, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28470366/technique-of-the-transobturator-puborectal-sling-in-fecal-incontinence
#18
C Brochard, M Queralto, P Cabarrot, L Siproudhis, G Portier
BACKGROUND: The puborectoplasty in fecal incontinence (FI) has been described through retropubic approach. Here, we describe a puborectal sling placement through transobturator approach with a device used for vaginal vault prolapse and report long-term outcome at 5 years. METHODS: Six women with FI for whom usual treatments (including sacral nerve stimulation) have failed were enrolled in a pilot study. Cleveland Clinic Incontinence Score (CCIS) and FI quality of life (FIQL) were used to evaluate results...
May 3, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28470364/sacral-nerve-stimulation-for-constipation-history-of-an-unconsummated-marriage
#19
EDITORIAL
J Martellucci
No abstract text is available yet for this article.
May 3, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28445906/-bipolar-stimulation-may-improve-the-efficacy-of-the-percutaneous-nerve-evaluation-test-of-sacral-neuromodulation
#20
André Reitz, Tanja Hüsch, Regula Doggweiler, Stephan Buse, Axel Haferkamp
Purpose This study evaluates the hypothesis that bipolar stimulation of the S3 and S4 sacral roots may enhance the efficacy of the percutaneous nerve evaluation (PNE) test. Material and Methods In this case-control-study, we enrolled 43 patients undergoing bipolar PNE and 57 controls undergoing unipolar PNE. For bipolar PNE, four test electrodes were placed at the bilateral S3 and S4 roots. The electrodes at the S3 and S4 roots of each side were connected to obtain bipolar stimulation. The test protocol over eight days included unilateral and bilateral stimulation of the S3 and S4 sacral roots...
May 2017: Aktuelle Urologie
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