European experience with bilateral sacral neuromodulation in patients with chronic lower urinary tract dysfunction

Kerrebroeck, E.V. van; Scheepens, W.A.; Bie, Rob A. de; Weil, E.H.J.

doi:10.1016/j.ucl.2004.09.011

Cited by 28 publications

(22 citation statements)

References 18 publications

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“…1 Published success rates for all approved uses range from 40% to 80%. [2][3][4][5][6] Common practice involves staged implantation of the sacral neurostimulator. Stage I entails percutaneous placement of a quadripolar tined lead into the right or left third sacral (S3) foramina under fluoroscopic guidance.…”

Section: Introductionmentioning

confidence: 99%

Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunction

Pham

Guralnick

O'Connor

2008

Neurourology and Urodynamics

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Section: Introductionmentioning

confidence: 99%

Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunction

Pham

Guralnick

O'Connor

2008

Neurourology and Urodynamics

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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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“…[13] Hence when unilateral percutaneous nerve stimulation fails, a bilateral test can be contemplated. [14,15] …”

Section: Bilateral Versus Unilateral Stimulationmentioning

confidence: 99%

Successful sacral nerve modulation despite migration of tined lead

Dekkers

Schmitz

Heyden

et al. 2016

CSS

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Background: Sacral nerve modulation (SNM) is a minimally invasive treatment for chronic constipation or incontinence when conservative treatment is insufficient to provide relieve of symptoms. Case description: A 74-year-old patient with an implanted sacral nerve lead is presented in this case report with a dislodged lead without an adverse change in her incontinence treatment. This phenomenon has never been described before and raises the debate on sacral lead positioning in sacral nerve stimulation. Discussion: There are a lot of conflicting data regarding ideal lead positioning, such as S3 versus S2 or S4 implantation. The lead position in our case doesn't correspond to previously described locations and pathways which corroborate the legitimacy of new developments in this area such as percutaneous tibial nerve stimulation, transcutaneous tibial nerve stimulation and transcutaneous abdominal electrical stimulation (TEN). Conclusions: The implantation of SNM seems standardized but leaves voids in the technique where further research is needed to refine it.

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European experience with bilateral sacral neuromodulation in patients with chronic lower urinary tract dysfunction

Cited by 28 publications

References 18 publications

Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunction

Unilateral versus bilateral stage I neuromodulator lead placement for the treatment of refractory voiding dysfunction

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

Successful sacral nerve modulation despite migration of tined lead

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