Bilateral Caudal Epidural Neuromodulation for Refractory Urinary Retention: A Salvage Procedure

Maher, Mary Grey; Mourtzinos, Arthur; Zabihi, Nasim; Laiwalla, U. Zehra; Raz, Shlomo; Rodríguez, Larissa V.

doi:10.1016/j.juro.2007.01.147

Cited by 15 publications

(4 citation statements)

References 17 publications

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“…In all patients in our series, the failure of the previous “Interstim‐Therapy” was not due to a wrong placement of the lead since urodynamic testing and examination of the lower extremities had confirm the proper stimulation of the sacral nerve root S2 or S3, but was due obviously to the number of the roots reached by the stimulation. Recent studies seem to confirm this hypothesis that the efficacy of neuromodulation could depend on the kind and/or amount of afferent fibers included in the electrical field (17–19). Pudendal stimulation also shows promising results for treatment of BO (20) and interstitial cystitis (21).…”

Section: Discussionmentioning

confidence: 93%

The laparoscopic implantation of neuroprothesis to the sacral plexus for therapy of neurogenic bladder dysfunctions after failure of percutaneous sacral nerve stimulation

Possover

2010

Neuromodulation: Technology at the Neural Interface

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Section: Discussionmentioning

confidence: 93%

The laparoscopic implantation of neuroprothesis to the sacral plexus for therapy of neurogenic bladder dysfunctions after failure of percutaneous sacral nerve stimulation

Possover

2010

Neuromodulation: Technology at the Neural Interface

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“…17 Ongoing investigations should focus on those factors increasing the success rate of first stage of SNM; for example, adopting bilateral SNM and the time/duration of efficacy after permanent SNM, thereby reducing the cost of this therapy and increasing the these patients' quality of life. [17][18][19][20] DATA ARCHIVING There were no data to deposit.…”

Section: Discussionmentioning

confidence: 99%

Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: a ten-year follow-up single-centre experience

Lombardi¹,

Musco²,

Celso³

et al. 2014

Spinal Cord

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Objective: To determine the success rate of percutaneous first stage of sacral neuromodulation (SNM) and the efficacy and safety of permanent SNM for incomplete spinal cord lesion (SCL) patients suffering from chronic neurogenic non-obstructive urinary retention (N-NOR). Method: From January 2003 to December 2012, 85 individuals underwent the percutaneous first stage of SNM. Subsequently, only responders who reached a concomitant reduction by at least 50% of volume per catheterization and in the number of catheterizations per day comparing their 7-day voiding diaries at baseline underwent permanent SNM. Final follow-up was conducted by April 2013. Results: Thirty-six individuals responded to percutaneous first stage of SNM. Post-surgery urodynamics documented all patients experiencing first sensation of bladder filling. A statistically significant increase in Qmax ml per sec and decrease in post-voiding residual urine per ml were documented. (Po0.01). First sensation of bladder filling at baseline represented a statistically significant parameter for the success of the first stage SNM (Po0.05). Eleven out of 34 patients at follow-ups were 'inconstant responders' because they returned to similar baseline voiding symptoms, but responded again with an implant on the controlateral S3 sacral root. Two failed twice and responded once again after an S4 sacral root implant. All but one failure occurred more than 3 years after the previous implant. Other drawbacks were resolved telemetrically. Keywords: neurogenic non-obstructive urinary retention; sacral neuromodulation; aseptic intermittent catheterizations; urodynamics INTRODUCTION Neurogenic non-obstructive urinary retention (N-NOR) due to spinal cord lesion (SCL) may be treated with pelvic floor reeducation, or drugs such as alpha-blockers and parasympathomimetics, though these therapies are commonly unsuccessful. 1,2 Moreover, literature reports that with intravesical electrostimulation patients regained detrusor activity and increased awareness of bladder filling. 3,4 However, other authors show negative findings. 5,6 A recent review on the use of sacral neuromodulation (SNM) for neurogenic lower urinary tract dysfunction reports that no definitive conclusions can be drawn from the available evidence regarding this procedure for neurogenic lower urinary tract dysfunction. 7 The aim of this retrospective study is to address the success rate percentage of first stage SNM in individuals with an incomplete SCL. Moreover, medium-and long-term efficacy associated with the safety of permanent SNM on SCL subjects suffering from N-NOR were evaluated.

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“…Eighteen patients reported more than a 50% improvement in QOL (Aboseif et al, 2002). New approaches of bilateral caudal neuromodulation might yield excellent outcome in patients with urinary retention refractory to traditional, unilateral S3 stimulation (Maher et al, 2007).…”

Section: Clinical Efficacymentioning

confidence: 99%

Neuromodulation in Management of Overactive Bladder

Oh-oka¹

2012

Topics in Neuromodulation Treatment

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Bilateral Caudal Epidural Neuromodulation for Refractory Urinary Retention: A Salvage Procedure

Abstract: To our knowledge this is the first report of the use of bilateral caudal epidural neuromodulation for refractory urinary retention. This therapy can be successful in patients in whom prior InterStim therapy failed.

Cited by 15 publications

References 17 publications

The laparoscopic implantation of neuroprothesis to the sacral plexus for therapy of neurogenic bladder dysfunctions after failure of percutaneous sacral nerve stimulation

The laparoscopic implantation of neuroprothesis to the sacral plexus for therapy of neurogenic bladder dysfunctions after failure of percutaneous sacral nerve stimulation

Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: a ten-year follow-up single-centre experience

Neuromodulation in Management of Overactive Bladder

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