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Sacral nerve stimulation

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https://www.readbyqxmd.com/read/28071947/presacral-abscess-as-a-rare-complication-of-sacral-nerve-stimulator-implantation
#1
A Gumber, S Ayyar, H Varia, S Pettit
A 50-year-old man with intractable anal pain attributed to proctalgia fugax underwent insertion of a sacral nerve stimulator via the right S3 vertebral foramen for pain control with good symptomatic relief. Thirteen months later, he presented with signs of sepsis. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a large presacral abscess. MRI demonstrated increased enhancement along the pathway of the stimulator electrode, indicating that the abscess was caused by infection introduced at the time of sacral nerve stimulator placement...
January 10, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28035463/sacral-nerve-stimulation-for-faecal-incontinence-in-patients-with-sacral-malformation
#2
M Brunner, Z Cui, K E Matzel
INTRODUCTION: Sacral nerve stimulation (SNS) is a common and effective treatment for faecal incontinence (FI), but accessibility of the sacral nerves is mandatory. In some cases, electrode placement fails for unknown reasons. A frequent cause could be sacral malformations, which have a high incidence (up to 24.1%) and can be unsuspected. METHODS AND RESULTS: We report two patients with FI consequent to congenital anorectal malformation and associated sacral malformation...
December 30, 2016: International Journal of Colorectal Disease
https://www.readbyqxmd.com/read/28000184/-to-improve-the-surgical-outcome-of-chronic-constipation-from-bed-to-the-bench
#3
Weidong Tong, Li Wang
The prevalence of chronic constipation is about 16% in adults, and increases with age, especially after 60 years old. Usually, surgical intervention is recommended to patients with long standing intractable constipation, who have undergone various conservative therapies. Lots of surgical procedures have been reported for different kinds of constipation, including slow transit, outlet obstruction, etc. For slow transit constipation, total or subtotal colectomy is commonly used. Merely for the internal rectal prolapse, at least 10 procedures are commonly adopted in clinic...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28000183/-operation-key-points-and-efficacy-evaluation-of-jinling-procedure-for-mixed-refractory-constipation
#4
Jun Jiang, Qiyi Chen
For chronic transit constipation (STC), surgery should be considered when all pharmacological interventions, biofeedback, and sacral nerve stimulation failed to relieve severe symptoms. Chronic functional constipation can be subdivided into three subtypes: colonic slow-transit constipation, outlet obstruction and mixed refractory constipation. The pathological changes of colonic slow transit and outlet obstruction constipation can influence each other. Mixed refractory constipation accounts for 90.2% of chronic constipation...
December 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/27997083/acute-sacral-nerve-stimulation-reduces-visceral-mechanosensitivity-in-a-cross-organ-sensitization-model
#5
L D Langlois, E Le Long, M Meleine, M Antor, K Atmani, P Dechelotte, A M Leroi, G Gourcerol
BACKGROUND: Sacral nerve stimulation (SNS) is a surgical treatment of fecal and urinary incontinence that consists of inserting a stimulating electrode into one of the s3 or s4 sacral holes. In addition to the benefit of SNS in the treatment of incontinence, recent studies showed that SNS is effective in the treatment of irritable bowel syndrome as well as bladder pain syndrome. The aim of this study was to evaluate the effect of SNS on visceral mechanosensitivity in a cross-organ sensitization rat model...
November 7, 2016: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/27935110/involvement-of-opioid-receptors-in-inhibition-of-bladder-overactivity-induced-by-sacral-neuromodulation-in-pigs-a-possible-action-mechanism
#6
Xing Li, Limin Liao, Guoqing Chen, Zhaoxia Wang, Han Deng
AIMS: To determine the role of opioid receptors in the inhibition of bladder overactivity by sacral neuromodulation (SNM) in pigs, and explore the possible mechanism of SNM. METHODS: Both implant-driven stimulators of the S3 spinal nerve were implanted in seven pigs. Naloxone and tramadol were administered. Multiple cystometrograms were performed to determine the effects of SNM and opioid receptors on the micturition reflex by infusing normal saline (NS) or acetic acid (AA)...
December 9, 2016: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/27920880/conditional-electrical-stimulation-in-animal-and-human-models-for-neurogenic-bladder-working-toward-a-neuroprosthesis
#7
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
#8
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
#9
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
#10
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...
December 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
#11
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...
January 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27816462/-lower-urinary-tract-dysfunction-in-normal-pressure-hydrocephalus-review-of-the-literature
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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