Peripheral and Sacral Neuromodulation in the Treatment of Neurogenic Lower Urinary Tract Dysfunction

Romo, Paholo G. Barboglio; Gupta, Priyanka

doi:10.1016/j.ucl.2017.04.011

Cited by 15 publications

(4 citation statements)

References 32 publications

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“…Use of SNS in patients with MS is only anecdotal, and, learning from the bladder experience, should be reserved to selected patients with stable relapsing remitting disease who had no relapses for at least 2 years 80. A crucial issue is not only the progression of disease and consequent loss of efficacy, but also the need for MRI scans which might require explantation of the stimulator.…”

Section: Methodsmentioning

confidence: 99%

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Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies

Preziosi¹,

Gordon–Dixon²,

Emmanuel³

2018

DNND

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Bowel dysfunction in patients with multiple sclerosis (MS) is highly prevalent. Constipation and fecal incontinence can coexist and alternate, impacting on the patient’s quality of life and social interactions, as well as burdening the caregivers. The cost for the health care providers is also significant, with increased number of hospital admissions, treatment-related costs, and hospital appointments. The origin is multifactorial, and includes alteration of neurological pathways, polypharmacy, behavioral elements, and ability to access the toilet. Every patient with MS should be sensitively questioned about bowel function, and red flag symptoms should prompt adequate investigations. Manipulation of life style factors and establishment of a bowel regime should be attempted in the first place, and if this fails, other measures such as biofeedback and transanal irrigation should be included. A stoma can improve quality of life, and is not necessarily a last-ditch option. Antegrade colonic enemas can also be an effective option, whilst neuromodulation has not proved its role yet. Effective treatment of bowel dysfunction improves quality of life, reduces incidence of urinary tract infection, and reduces health care costs.

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Section: Methodsmentioning

confidence: 99%

“…Posterior tibial nerve stimulation has shown promising results for the treatment of bladder dysfunction in MS patient,80 but studies on bowel dysfunction are very much needed.…”

Section: Methodsmentioning

confidence: 99%

Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies

Preziosi¹,

Gordon–Dixon²,

Emmanuel³

2018

DNND

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“…Potential new treatments for controlling neuropathic pain, spasticity, bladder, and intestinal functions have also been extensively studied. Those include electrical spinal cord stimulation, chemical neuromodulation [17], drug delivery pumps with catheters inserted in the subarachnoid space [18] and sacral stimulators [19–21].…”

Section: Introductionmentioning

confidence: 99%

Training with brain-machine interfaces, visuo-tactile feedback and assisted locomotion improves sensorimotor, visceral, and psychological signs in chronic paraplegic patients

Shokur¹,

Donati

Campos³

et al. 2018

PLoS ONE

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Spinal cord injury (SCI) induces severe deficiencies in sensory-motor and autonomic functions and has a significant negative impact on patients’ quality of life. There is currently no systematic rehabilitation technique assuring recovery of the neurological impairments caused by a complete SCI. Here, we report significant clinical improvement in a group of seven chronic SCI patients (six AIS A, one AIS B) following a 28-month, multi-step protocol that combined training with non-invasive brain-machine interfaces, visuo-tactile feedback and assisted locomotion. All patients recovered significant levels of nociceptive sensation below their original SCI (up to 16 dermatomes, average 11 dermatomes), voluntary motor functions (lower-limbs muscle contractions plus multi-joint movements) and partial sensory function for several modalities (proprioception, tactile, pressure, vibration). Patients also recovered partial intestinal, urinary and sexual functions. By the end of the protocol, all patients had their AIS classification upgraded (six from AIS A to C, one from B to C). These improvements translated into significant changes in the patients’ quality of life as measured by standardized psychological instruments. Reexamination of one patient that discontinued the protocol after 12 months of training showed that the 16-month break resulted in neurological stagnation and no reclassification. We suggest that our neurorehabilitation protocol, based uniquely on non-invasive technology (therefore necessitating no surgical operation), can become a promising therapy for patients diagnosed with severe paraplegia (AIS A, B), even at the chronic phase of their lesion.

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“…The application of sacral neuromodulation (SNM) has been widened to the treatment of nonobstructive urinary retention, pelvic pain, NB, as well as intractable overactive bladder and fecal incontinence in urological practice . Despite some small studies that showed positive results regarding the effect of SNM on NB, the presence of the underlying neurologic deficiency has been regarded as one of the predictors for poor bladder response to SNM.…”

Section: Introductionmentioning

confidence: 99%

Effect of Early Sacral Neuromodulation on Bladder Function in a Rat Model of Incomplete Spinal Cord Injury Due to Focal Contusion

Lee

Yoon

Lee

et al. 2019

Neuromodulation: Technology at the Neural Interface

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Peripheral and Sacral Neuromodulation in the Treatment of Neurogenic Lower Urinary Tract Dysfunction

Cited by 15 publications

References 32 publications

Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies

Neurogenic bowel dysfunction in patients with multiple sclerosis: prevalence, impact, and management strategies

Training with brain-machine interfaces, visuo-tactile feedback and assisted locomotion improves sensorimotor, visceral, and psychological signs in chronic paraplegic patients

Effect of Early Sacral Neuromodulation on Bladder Function in a Rat Model of Incomplete Spinal Cord Injury Due to Focal Contusion

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