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Sacral neuromodulation

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
David A Ginsberg
No abstract text is available yet for this article.
October 11, 2016: Journal of Urology
Steven Siegel
No abstract text is available yet for this article.
October 11, 2016: Journal of Urology
Jathin Bandari, Utsav Bansal, Zhaocun Zhang, Bing Shen, Jicheng Wang, Vladimir Lamm, Victor Chang, James R Roppolo, William C de Groat, Changfeng Tai
OBJECTIVE: To determine the role of opioid, β-adrenergic, and metabotropic glutamate 5 receptors in sacral neuromodulation of bladder overactivity. MATERIAL AND METHODS: In α-chloralose anesthetized cats, intravesical infusion of 0.5% acetic acid (AA) irritated the bladder and induced bladder overactivity. Electric stimulation (5 Hz, 0.2 ms, 0.16-0.7V) of S1 or S2 sacral dorsal roots inhibited the bladder overactivity. Naloxone, propranolol, or MTEP were given intravenously (i...
October 12, 2016: Neuromodulation: Journal of the International Neuromodulation Society
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
Xuewen Jiang, Thomas W Fuller, Jathin Bandari, Utsav Bansal, Zhaocun Zhang, Bing Shen, Jicheng Wang, James R Roppolo, William C de Groat, Changfeng Tai
In α-chloralose anesthetized cats, we examined the role GABAA, glycine, and opioid receptors in sacral neuromodulation-induced inhibition of bladder overactivity elicited by intravesical infusion of 0.5% acetic acid (AA). AA irritation significantly (p<0.01) reduced bladder capacity to 59.5±4.8% of saline control. S1 or S2 dorsal root stimulation at threshold intensity for inducing reflex twitching of the anal sphincter or toe significantly (p<0.01) increased bladder capacity to 105.3±9.0% and 134...
October 11, 2016: Journal of Pharmacology and Experimental Therapeutics
Abdullah A Gahzi, Dean S Elterman, Magdy Hassouna
The objective of this study was to describe our experience using sacral neuromodulation to treat urinary urgency, frequency, urge incontinence, and chronic urinary retention in patients with cardiac pacemakers. With the increasingly widespread use of InterStim for bladder function restoration, we are seeing more complex patients with multiple comorbidities, including cardiac conditions. Herein, we report 3 cases of individuals with cardiac pacemakers who underwent InterStim implantation to treat urinary conditions...
September 2016: International Neurourology Journal
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
Matthew E Sterling, Siobhan M Hartigan, Alan J Wein, Ariana L Smith
INTRODUCTION: Explantation of the Interstim sacral neuromodulation (SNM) device is occasionally necessary. Removing the tined lead can put strain on the lead, resulting in a possible break and retained fragments. The Food and Drug Administration (FDA) released a notification regarding health consequences related to retained lead fragments. We describe a novel and safe surgical technique for removing the Interstim device and permanent lead. MATERIALS AND METHODS: We searched the Manufacturer and User Facility Device Experience (MAUDE) database for complications related to tined lead removal and searched the database of a single surgeon at our institution...
October 2016: Canadian Journal of Urology
Cindy L Amundsen, Holly E Richter, Shawn A Menefee, Yuko M Komesu, Lily A Arya, W Thomas Gregory, Deborah L Myers, Halina M Zyczynski, Sandip Vasavada, Tracy L Nolen, Dennis Wallace, Susan F Meikle
Importance: Women with refractory urgency urinary incontinence are treated with sacral neuromodulation and onabotulinumtoxinA with limited comparative information. Objective: To assess whether onabotulinumtoxinA is superior to sacral neuromodulation in controlling refractory episodes of urgency urinary incontinence. Design, Setting, and Participants: Multicenter open-label randomized trial (February 2012-January 2015) at 9 US medical centers involving 381 women with refractory urgency urinary incontinence...
October 4, 2016: JAMA: the Journal of the American Medical Association
Helene Dessort, Evelyne Castel-Lacanal, Xavier de Boissezon, Philippe Marque
OBJECTIVE: Intermittent self-catheterization is the gold standard for patients with central neurologic bladder. It allows to reduce all urinary tract complications and to improve the quality of life. The factors of good compliance are continence and autonomy regarding the introduction of the catheter. Nevertheless, self-catheterization can be difficult because of the usual shortcomings associated with bladder and sphincter disorders (motor, sensory…). We found only one study about one adaptive equipment to facilitate the gesture for monoplegic patients...
September 2016: Annals of Physical and Rehabilitation Medicine
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
Jamie M Bartley, Kim A Killinger, Judith A Boura, Priyanka Gupta, Natalie Gaines, Jason P Gilleran, Kenneth M Peters
AIMS: To evaluate neuromodulation outcomes in patients with prior back surgery. METHODS: Adults in our prospective observational sacral/pudendal neuromodulation study were retrospectively evaluated. History and operative details were reviewed, and outcomes were measured at 3, 6, 12, and 24 months with overactive bladder questionnaire (OAB q) symptom severity (SS)/health related quality of life (HRQOL), interstitial cystitis symptom/problem indices (ICSI - PI), voiding diaries, and global response assessments (GRA)...
September 27, 2016: Neurourology and Urodynamics
Jamie M Bartley, Verity Ramirez, Kim A Killinger, Judith A Boura, Priyanka Gupta, Natalie Gaines, Jason P Gilleran, Kenneth M Peters
OBJECTIVES: The aim of this study was to evaluate the efficacy of sacral neuromodulation in patients with prior stress urinary incontinence (SUI) or pelvic organ prolapse (POP) surgery. METHODS: Women in our prospective neuromodulation database were evaluated. Patients with a history of prior SUI/POP surgery were compared to those without. Medical records at baseline were reviewed, and primary outcome was defined as moderate/marked improvement on Global Response Assessment (GRA) at 3 months...
September 15, 2016: Female Pelvic Medicine & Reconstructive Surgery
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
Nathan Hoag, Sophie Plagakis, Samantha Pillay, Ailsa Wilson Edwards, Johan Gani
AIMS: Sacral neuromodulation (SNM) is a well-established treatment modality for refractory overactive bladder (OAB). There is a paucity of evidence examining the use of SNM in patients who have received prior intravesical onabotulinumtoxinA (BTXA) treatment. We aim to review those patients who underwent SNM for refractory OAB following treatment with BTXA. METHODS: A retrospective review was conducted to identify patients who had undergone prior intradetrusor BTXA for refractory OAB, then subsequent first-stage SNM...
September 9, 2016: Neurourology and Urodynamics
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
Zhaocun Zhang, Jathin Bandari, Utsav Bansal, Bing Shen, Jicheng Wang, Vladimir Lamm, James R Roppolo, William C de Groat, Changfeng Tai
AIMS: To investigate the effects of electrical stimulation of sacral dorsal/ventral roots on irritation-induced bladder overactivity, reveal possible different mechanisms under nociceptive bladder conditions, and establish a large animal model of sacral neuromodulation. METHODS: Intravesical infusion of 0.5% acetic acid (AA) was used to irritate the bladder and induce bladder overactivity in cats under α-chloralose anesthesia. Electrical stimulation (5, 15, or 30 Hz) was applied to individual S1-S3 dorsal or ventral roots at or below motor threshold intensity...
August 29, 2016: Neurourology and Urodynamics
Gwendolyn M Beer, Margaret M Gurule, Yuko M Komesu, Clifford R Qualls, Rebecca G Rogers
This is a randomized, controlled, blind, crossover trial comparing cycling versus continuous programming of a sacral neuromodulator in women diagnosed with overactive bladder (OAB). At 6 months, treatment order significantly affected Overactive Bladder Questionnaire - Short Form (OABq-SF) symptom scores. The cycling followed by continuous stimulation group had superior OABq-SF scores (p > 0.02).
May 2016: Urologic Nursing
Jennifer T Anger, Anne P Cameron, Rodger Madison, Christopher Saigal, J Quentin Clemens
OBJECTIVE: In this study, we analyzed claims data from the Ingenix data base to analyze outcomes of sacral neuromodulation with respect to both provider and patient factors. MATERIALS AND METHODS: We used the Ingenix (I3) data base to determine demographic, diagnosis, and procedure success information for years 2002-2007 for privately insured patients. Demographic information was obtained, as were the diagnoses given and procedures performed, based on ICD-9 diagnosis codes and Current Procedural Terminology procedure codes...
October 2016: Neuromodulation: Journal of the International Neuromodulation Society
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