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Sacral neuromodulation

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https://www.readbyqxmd.com/read/28727899/sacral-neuromodulation-for-combined-faecal-and-urinary-incontinence-following-obstetric-anal-sphincter-injury
#1
M Rydningen, Stine Riise, T Wilsgaard, R O Lindsetmo, S Norderval
AIM: The aim of this study was to investigate the efficacy of sacral neuromodulation (SNM) in the treatment of faecal incontinence and concomitant urinary incontinence in women with a history of obstetric anal sphincter injury (OASIS). METHOD: In this prospective study, consecutive women with faecal incontinence following OASIS accepted for SNM were screened for concomitant urinary incontinence. The primary outcome was the change in urinary incontinence score (ICIQ-UI-SF) between baseline and 12 months...
July 20, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28727645/retroperitoneal-hemorrhage-after-sacral-neurostimulator-placement-for-urgency-urinary-incontinence
#2
Casey L Kinman, Deslyn T G Hobson, Anubhav Agrawal, Martin S Vyleta, Sean L Francis
Sacral neuromodulation (SNM) is an effective therapy for patients who experience urinary incontinence, idiopathic urinary retention, and fecal incontinence. Although typically a low-risk procedure, rarely, it can be associated with significant hemorrhage. A 61-year-old woman on chronic anticoagulation underwent uncomplicated implantation of SNM for refractory urgency urinary incontinence. Anticoagulation was held on the day of surgery and resumed on postoperative day 1. On postoperative day 2, the patient developed an extensive retroperitoneal hemorrhage...
July 20, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28723864/sacral-neuromodulation-for-fecal-incontinence-a-review-of-the-central-mechanisms-of-action
#3
Paul T J Janssen, Niels Komen, Jarno Melenhorst, Nicole D Bouvy, Ali Jahanshahi, Yasin Temel, Stephanie O Breukink
OBJECTIVE: Fecal incontinence (FI) has a devastating effect on the quality of life and results in social isolation. Sacral neuromodulation (SNM) is proven to be an effective, minimal invasive treatment modality for FI. Despite the increasing application of SNM, the exact mechanisms of action remain unclear. The initial assumption of peripheral motor neurostimulation is not supported by increasing evidence, which report effects of SNM outside the pelvic floor. A new hypothesis states that afferent signals to the brain are essential for a successful therapy...
July 18, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28718163/incidence-and-management-of-lower-urinary-tract-symptoms-after-urethral-stricture-repair
#4
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/28716325/peripheral-and-sacral-neuromodulation-in-the-treatment-of-neurogenic-lower-urinary-tract-dysfunction
#5
REVIEW
Paholo G Barboglio Romo, Priyanka Gupta
Sacral and peripheral neuromodulation are minimally invasive surgical procedures that are third-line therapy options for the treatment of patients with idiopathic overactive bladder syndrome. There has been interest in their efficacy in the management of neurogenic lower urinary tract dysfunction (NLUTD). Contemporary data suggest promising outcomes for urinary and bowel symptoms in carefully selected patients with spinal cord injury and/or multiple sclerosis. This article reviews the current literature regarding urinary and bowel outcomes in patients with NLUTD and also discusses contemporary studies that suggest that treatment during particular stages of neurologic injury may prevent long-term urinary sequelae...
August 2017: Urologic Clinics of North America
https://www.readbyqxmd.com/read/28709886/five-year-follow-up-results-of-a-prospective-multicenter-study-in-overactive-bladder-subjects-treated-with-sacral-neuromodulation
#6
Steven Siegel, Karen Noblett, Jeffrey Mangel, Jason Bennett, Tomas L Griebling, Suzette E Sutherland, Erin T Bird, Craig Comiter, Daniel Culkin, Samuel Zylstra, Fangyu Kan, Kellie Chase Berg
OBJECTIVE: To evaluate therapeutic success rate, changes in quality of life (QOL) and safety with sacral neuromodulation (SNM) at 5 years after InterStim™ implant. Subjects with bothersome symptoms of overactive bladder (OAB) including urinary urge incontinence (UI) and/or urgency-frequency (UF), who had failed at least 1 anticholinergic medication and had at least 1 medication untried were included. METHODS: Therapeutic success was defined as a UI or UF response: ≥ 50% improvement in average leaks or voids/day or a return to normal voiding (<8 voids/day)...
July 11, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28676364/neurogenic-pelvic-pain
#7
REVIEW
Nicholas Elkins, Jason Hunt, Kelly M Scott
Pelvic neuralgias frequently cause severe pain and may have associated bladder, bowel, or sexual dysfunctions which also impact quality of life. This article explores the etiology, epidemiology, presentation and treatment of common causes of neurogenic pelvic pain, including neuralgia of the border nerves (ilioinguinal, iliohypogastric, and genitofemoral), pudendal neuralgia, clunealgia, sacral radiculopathies caused by Tarlov cysts, and cauda equina syndrome. Treatment of pelvic neuralgia includes conservative measures such as pelvic physical therapy, lifestyle modification, and medications with escalation to more invasive and novel treatments such as nerve blocks, radiofrequency ablation, cryoablation, neuromodulation and neurectomy/neurolysis if conservative treatments are ineffective...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28673064/effects-of-acute-sacral-neuromodulation-at-different-frequencies-on-bladder-overactivity-in-pigs
#8
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/28658001/trends-and-clinical-practice-patterns-of-sacral-neuromodulation-for-overactive-bladder
#9
Dean S Elterman, Bilal Chughtai, Emily Vertosick, Dominique Thomas, James Eastham, Jaspreet Sandhu
OBJECTIVES: The aim of this study was to investigate surgical practice patterns of American urologists treating refractory overactive bladder (OAB) over the past decade. Refractory OAB remains a management challenge to urologists. When multiple medical therapies have failed, treatment options may include sacral neuromodulation (SNM) or surgery such as augmentation cystoplasty (AC). METHODS: Data on SNM and AC performed between 2003 and 2012 by certifying and recertifying urologists were obtained in the form of annualized case logs from the American Board of Urology (ABU)...
June 27, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28656519/where-are-we-headed-with-neuromodulation-for-overactive-bladder
#10
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/28650898/retroperitoneal-hemorrhage-after-sacral-neurostimulator-placement-for-urgency-urinary-incontinence
#11
Casey L Kinman, Deslyn T G Hobson, Anubhav Agrawal, Martin S Vyleta, Sean L Francis
Sacral neuromodulation (SNM) is an effective therapy for patients who experience urinary incontinence, idiopathic urinary retention, and fecal incontinence. Although typically a low-risk procedure, rarely, it can be associated with significant hemorrhage. A 61-year-old woman on chronic anticoagulation underwent uncomplicated implantation of SNM for refractory urgency urinary incontinence. Anticoagulation was held on the day of surgery and resumed on postoperative day 1. On postoperative day 2, the patient developed an extensive retroperitoneal hemorrhage...
July 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28645869/real-time-changes-in-brain-activity-during-sacral-neuromodulation-for-overactive-bladder
#12
Bradley C Gill, Javier Pizarro Berdichevsky, Pallab K Bhattacharyya, Thaddeus S Brink, Brian K Marks, Adrienne Quirouet, Sandip P Vasavada, Stephen E Jones, Howard B Goldman
PURPOSE: To use functional magnetic resonance imaging(fMRI) for identifying changes in brain activity during sacral neuromodulation(SNM) in women with overactive bladder(OAB) who were responsive to therapy. MATERIALS AND METHODS: Women with non-neurogenic refractory OAB who responded to SNM, had a stable program for at least 3 months, with no subsequent OAB treatment were recruited. Enrolled patients completed pre-fMRI validated symptom and quality of life instruments...
June 20, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28644192/vulvodynia-younger-age-and-combined-therapies-associate-with-significant-reduction-in-self-reported-pain
#13
Anu P Aalto, Silja Vuoristo, Heidi Tuomaala, Riikka J Niemi, Synnöve M Staff, Johanna U Mäenpää
OBJECTIVES: Eight percent of women have vulvodynia (VD), a chronic pain disorder with unknown etiology. The aim of our study was to assess the efficacy of given VD treatments measured by numerical rating scale (NRS) for pain and patients' quality of life. MATERIALS AND METHODS: Study material consisted of a retrospective VD patient cohort (N = 70). Data were collected by postal questionnaires and review of the medical records. RESULTS: We report here a statistically significant reduction in NRS only with combination of therapies (median NRS before treatments 8 vs median NRS 4 after treatments, p < ...
July 2017: Journal of Lower Genital Tract Disease
https://www.readbyqxmd.com/read/28624555/sacral-neuromodulation-device-heating-during-lumbar-and-pelvic-mri-a-phantom-study
#14
A Quirouet, P K Bhattacharyya, E J Dielubanza, B C Gill, S E Jones, H B Goldman
OBJECTIVE: To evaluate radiofrequency induced temperature rises associated with performing lumbar and pelvic magnetic resonance imaging studies with an implanted sacral neuromodulation device using a phantom model. MATERIALS AND METHODS: An accepted phantom model of RF-induced heating in human tissue was used to measure the temperature rise in the stimulator lead electrodes and impulse generator under the conditions used during routine clinical lumbar and pelvic MRIs in a 1...
June 14, 2017: Urology
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/28526242/factors-predicting-complications-after-sacral-neuromodulation-in-children
#16
Molly E Fuchs, Peter L Lu, Stephanie J Vyrostek, Steven Teich, Seth A Alpert
OBJECTIVES: To identify if any pre-operative variable are associated with post-operative complications after pediatric sacral neuromodulation (SNM). METHODS: A review of all patients undergoing SNM with an implantable pulse generator at our institution was performed. Post-operative infection, lead migration, lead breakage and need for reoperation were recorded in a prospective database. We collected demographic information and indication for the procedure. We defined indication for procedure as either primarily bowel, or primarily bladder symptoms...
May 16, 2017: Urology
https://www.readbyqxmd.com/read/28505919/re-onabotulinumtoxina-vs-sacral-neuromodulation-on-refractory-urgency-urinary-incontinence-in-women-a-randomized-clinical-trial
#17
Alan J Wein
No abstract text is available yet for this article.
June 2017: Journal of Urology
https://www.readbyqxmd.com/read/28501541/characteristics-associated-with-treatment-response-and-satisfaction-in-women-undergoing-onabotulinumtoxina-and-sacral-neuromodulation-for-refractory-urgency-urinary-incontinence
#18
Holly E Richter, C L Amundsen, S W Erickson, J E Jelovsek, Y Komesu, C Chermansky, H S Harvie, M Albo, D Myers, W T Gregory, D Wallace
PURPOSE: We sought to identify clinical and demographic characteristics associated with treatment response and satisfaction in women undergoing onabotulinumtoxinA and sacral neuromodulation therapies. MATERIALS AND METHODS: We analyzed data from the ROSETTA (Refractory Overactive Bladder: Sacral NEuromodulation versus BoTulinum Toxin Assessment) trial. Baseline participant characteristics and clinical variables were associated with 2 definitions of treatment response, including 1) a reduction in mean daily urgency incontinence episodes during 6 months and 2) a 50% or greater decrease in urgency incontinence episodes across 6 months...
May 10, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28451766/sacral-neurostimulation-for-low-anterior-resection-syndrome-after-radical-resection-for-rectal-cancer-evaluation-of-treatment-with-the-lars-score
#19
M D'Hondt, F Nuytens, L Kinget, M Decaestecker, B Borgers, I Parmentier
PURPOSE: Sacral neurostimulation (SNS) has proven to be an effective treatment modality for low anterior resection syndrome (LARS). The primary aim of this study is to investigate the impact of SNS on all symptoms of LARS, not merely on fecal incontinence. Furthermore, we wanted to evaluate whether the LARS score could be useful as a tool to evaluate SNS treatment. METHODS: All patients diagnosed with minor or major LARS, unresponsive to conservative therapy for fecal incontinence, who underwent sacral neuromodulation for LARS at Groeninge Hospital, Kortrijk, Belgium, were prospectively enrolled in the study...
April 27, 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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