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Sacral neuromodulation

Manuela Tutolo, Enrico Ammirati, Frank Van der Aa
Although both intravesical onabotulinumtoxinA injections and sacral neuromodulation could be offered in cases of bladder pain syndrome and overactive bladder syndrome, there is still no scientific agreement on the best option after failure of standard therapies.
March 15, 2018: European Urology Focus
Richard P Nobrega, Eskinder Solomon, Julie Jenks, Tamsin Greenwell, Jeremy Ockrim
AIMS: To assess whether the urodynamic parameters of mean voided volume, peak detrusor overactivity (DO) pressure, bladder compliance, capacity, and volume at first detrusor overactivity during filling cystometry can predict a successful outcome at first stage tined lead placement (FSTLP). METHODS: Ninty-nine consecutive patients with urodynamically proven idiopathic detrusor overactivity (IDO) refractory to medical treatment and opting for Sacral Nerve Stimulation (SNS), were assessed pre and post FSTLP...
March 6, 2018: Neurourology and Urodynamics
Ranjana Jairam, Jamie Drossaerts, Desiree Vrijens, Carsten Leue, Philip van Kerrebroeck, Gommert van Koeveringe
AIMS: Sacral neuromodulation (SNM) is an effective treatment for patients with overactive bladder syndrome (OAB) or non-obstructive urinary retention (NOR). These lower urinary tract symptoms (LUTS) are the result of a functional urological cause but often coincide with psychological and/or psychiatric factors. It has been stated that there is an association between LUTS, depression and anxiety disorders. With this study we will investigate whether affective symptoms and quality of life (QoL) improve after successful SNM...
March 5, 2018: Neurourology and Urodynamics
Abdullah Ahmed Ghazi, Malak Abuzgaya, Mai Banakhar, Magdy Hassouna
Objective: The aim of the current research project was to study the role of the Neurometer® as a tool to predict responders to sacral neuromodulation therapy (SNM). Material and methods: This was a prospective, open study in male and female patients, aged 18 and over with voiding dysfunction [non-obstructive retention and/or frequency/ urgency syndrome]. The first group underwent a screening test to evaluate percutaneous nerve functions (PNE) and to determine whether they are candidates for SNM with the InterStim® ...
January 2018: Turkish Journal of Urology
Cindy L Amundsen, Yuko M Komesu, Christopher Chermansky, W Thomas Gregory, Deborah L Myers, Emily F Honeycutt, Sandip P Vasavada, John N Nguyen, Tracey S Wilson, Heidi S Harvie, Dennis Wallace
BACKGROUND: Urgency urinary incontinence (UUI) is a chronic condition for which sacral neuromodulation (SNM) (InterStim/Medtronic) and onabotulinumtoxinA (BTX) (BotoxA/Allergan) are utilized. These therapies have not been compared over extended time. OBJECTIVE: To compare UUI episodes (UUIE) over 24 mo following SNM or BTX. DESIGN, SETTING, AND PARTICIPANTS: Multicenter, open-label, randomized, extension trial (February 2012-July 2016) at nine US medical centers involving 386 women with ≥6 UUIE over 3 d inadequately managed by medications...
February 23, 2018: European Urology
S C M Heemskerk, A H Rotteveel, M A Benninga, C I M Baeten, A A M Masclee, J Melenhorst, S M J van Kuijk, C D Dirksen, S O Breukink
PURPOSE: The evidence regarding the (cost-)effectiveness of sacral neuromodulation (SNM) in patients with therapy-resistant idiopathic slow-transit constipation is of suboptimal quality. The Dutch Ministry of Health, Welfare and Sports has granted conditional reimbursement for SNM treatment. The objective is to assess the effectiveness, cost-effectiveness, and budget impact of SNM compared to personalized conservative treatment (PCT) in patients with idiopathic slow-transit constipation refractory to conservative treatment...
February 22, 2018: International Journal of Colorectal Disease
Jaschar Shakuri-Rad, Arman Cicic, Jannah Thompson
OBJECTIVE: To investigate the use of intraoperative ultrasound during stage I InterStim® sacral lead placement. METHODS: A total of 40 patients were randomly assigned to undergo InterStim® lead placement utilizing fluoroscopy or ultrasound guidance. Patients were blinded for the duration of the study. The surgeon and staff were blinded until after induction of anesthesia. Patients met criteria for refractory overactive bladder, fecal incontinence, or both. The ICIQ-OABqol, OABSS, and FIQL validated questionnaires were used pre- and post-operatively...
February 21, 2018: Neurourology and Urodynamics
Bilal Chughtai, Dominique Thomas, Tianyi Sun, Art Sedrakyan
No abstract text is available yet for this article.
February 14, 2018: JAMA Surgery
Ursula S Hofstoetter, Brigitta Freundl, Heinrich Binder, Karen Minassian
Epidural electrical stimulation of the lumbar spinal cord is currently regaining momentum as a neuromodulation intervention in spinal cord injury (SCI) to modify dysregulated sensorimotor functions and augment residual motor capacity. There is ample evidence that it engages spinal circuits through the electrical stimulation of large-to-medium diameter afferent fibers within lumbar and upper sacral posterior roots. Recent pilot studies suggested that the surface electrode-based method of transcutaneous spinal cord stimulation (SCS) may produce similar neuromodulatory effects as caused by epidural SCS...
2018: PloS One
Alan J Wein
No abstract text is available yet for this article.
August 2017: Journal of Urology
Mohammad S Rahnama'i, Tom Marcelissen, Apostolos Apostolidis, Nikolaus Veit-Rubin, Brigitte Schurch, Linda Cardozo, Roger Dmochowski
AIMS: This manuscript aims to address the evidence availale in the literature on the efficacy of Botulinum Toxin A (BoNT-A) and sacral neuromodulation (SNM) in patients suffering from Interstitial Cystitis (IC)/BPS and propose further research to identify mechanisms of action and establish the clinical efficacy of either therapy. METHODS: At the International Consultation on Incontinence-Research Society (ICI-RS) in 2017, a panel of Functional Urologists and Urogynaecologists participated in a Think Tank (TT) discussing the management of IC/BPS by BoNT-A and SNM, using available data from both PubMed and Medicine literature searches...
January 24, 2018: Neurourology and Urodynamics
L Lagares-Tena, L Millán-Paredes, L Lázaro-García, A Navarro-Luna, S Delgado-Rivilla, A Muñoz-Duyos
BACKGROUND: The aim of the present study was to evaluate the effectiveness of sacral neuromodulation (SNM) as a treatment for congenital faecal incontinence (FI). METHODS: A retrospective study was conducted on patients with congenital FI who had SNM surgery at our institution between October 2005 and June 2013. An initial percutaneous nerve evaluation was performed, and patients with an improvement of more than 50% in their symptoms had permanently implants for SNM treatment...
January 16, 2018: Techniques in Coloproctology
Manuela Tutolo, Enrico Ammirati, John Heesakkers, Thomas M Kessler, Kenneth M Peters, Tina Rashid, Karl-Dietrich Sievert, Michele Spinelli, Giacomo Novara, Frank Van der Aa, Dirk De Ridder
CONTEXT: Neuromodulation is considered in patients with non-neurogenic lower urinary tract dysfunction (LUTD) not responsive to conservative treatment. OBJECTIVE: To systematically review the available studies on efficacy and safety of sacral neuromodulation (SNM) and percutaneous tibial nerve stimulation (PTNS) in non-neurogenic LUTDs not responsive to conservative treatments. EVIDENCE ACQUISITION: A literature research was conducted in PubMed/Medline and Scopus, restricted to articles in English, published between January 1998 and June 2017, with at least 20 patients and 6 mo of follow-up...
January 11, 2018: European Urology
Dean S Elterman
AIMS: The rechargeable Axonics® r-SNM™ System is currently approved and available in Europe and Canada, with US FDA approval pending. This article provides a review of the system along with technique and technical considerations for its implantation based on my clinical experience with the new Axonics r-SNM System. METHODS: The description of the surgical technique and technological considerations for the Axonics r-SNM System is based my clinical experience of 11 cases performed at UHN Toronto Western Hospital...
January 16, 2018: Neurourology and Urodynamics
Bertil Blok, Philip Van Kerrebroeck, Stefan de Wachter, Alain Ruffion, Frank Van der Aa, Ranjana Jairam, Marie Perrouin-Verbe, Sohier Elneil
AIMS: The RELAX-OAB study is designed to confirm the safety, efficacy, and technical performance of the Axonics r-SNM System, a miniaturized, rechargeable SNM system approved in Europe and Canada for the treatment of bladder and bowel dysfunction. The purpose of this article is to describe study subjects' ability to charge the rechargeable neurostimulator and to document their neurostimulator program settings and recharge interval over time. METHODS: Fifty-one OAB patients were implanted in a single-stage procedure...
February 2018: Neurourology and Urodynamics
A Schneider, B Tourlonias, L Cormier, E Mourey, N Koutlidis, E Delorme, J Pasquale, I Kermarec, A-D Foahom-Kamwa, V Bonniaud
INTRODUCTION: Since 2014, OnabotulinumtoxinA Botox® (Allergan, Inc., Irvine, USA) represents a new therapeutic option for second-line treatment of idiopathic overactive bladder. The purpose of the current study was to evaluate practices of surgeons using onabotulinium toxin (BoNTA) in this indication. MATERIAL AND METHODS: All urogynecology centers of the country were asked in order to list all patients who were treated since marketing autorisation. Patient symptoms, previous treatments, paraclinic evaluations, data of surgery and the characteristics of the follow up were collected and analyzed...
January 9, 2018: Progrès en Urologie
Eric Chung, Dominic Lee, Johan Gani, Michael Gillman, Christopher Maher, Janelle Brennan, Lydia Johns Putra, Laura Ahmad, Lewis Lw Chan
Overactive bladder (OAB) is a highly prevalent medical condition that has an adverse impact on various health-related quality-of-life domains, including a significant psychosocial and financial burden. This position statement, formulated by members of the Urological Society of Australia and New Zealand and the UroGynaecological Society of Australasia, summarises the current recommendations for clinical diagnosis and treatment strategies in patients with non-neurogenic OAB, and guides clinicians in the decision-making process for managing the condition using evidence-based medicine...
January 15, 2018: Medical Journal of Australia
Bertil Blok, Philip Van Kerrebroeck, Stefan de Wachter, Alain Ruffion, Frank Van der Aa, Ranjana Jairam, Marie Perrouin-Verbe, Sohier Elneil
AIMS: The primary aim of the RELAX-OAB study is to confirm the safety and efficacy of the Axonics r-SNM System, a miniaturized, rechargeable SNM system. METHODS: A total of 51 OAB patients were implanted in a single-stage implant procedure. These results represent the 3-month outcomes. Subject outcomes were evaluated using 3-day bladder diaries and quality of life questionnaires. RESULTS: A total of 31 of 34 patients (91%) that responded during an initial trial period ("Test Responders") continued to benefit from therapy with the Axonics r-SNM System at 3-months, defined as symptom improvement of ≥50% reduction in urinary voids or incontinence episodes or a return to <8 voids per day...
January 5, 2018: Neurourology and Urodynamics
Samina Tahseen
Sacral neuromodulation (SNM) offers promise in the therapy of many pelvic floor disorders. This innovative treatment has slowly gained popularity. A review of recent literature is presented in relation to its efficacy and complications in various pelvic floor conditions: overactive bladder and urge urinary incontinence, chronic urinary retention, painful bladder syndrome, pelvic pain and double incontinence. It is a minimally invasive, completely reversible safe procedure with good long-term outcomes. However, the treatment is costly, the revision rate is high and patients require life-long follow-up...
January 4, 2018: International Urogynecology Journal
Abdullah Ahmed Gahzi, Mai Ahmed Banakhar, Dean S Elterman, Magdy Hassouna
PURPOSE: Sacral neuromodulation (SNM) therapy is indicated for some refractory urological conditions. The electrode lead position in sacral x-rays during routine follow-up may predict the outcome of SNM therapy. To determine whether the radiographic position of the electrode in the sacral foramen predicted the long-term outcome of SNM therapy. METHODS: This was a retrospective study of patients who underwent InterStim SNM at Toronto Western Hospital by 2 surgeons from July 2013 to March 2014...
December 2017: International Neurourology Journal
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