Sacral nerve neuromodulation in patients with underlying neurologic disease

Wallace, Patricia A.; Lane, Felicia; Noblett, Karen

doi:10.1016/j.ajog.2007.04.016

Cited by 81 publications

(66 citation statements)

References 14 publications

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“…SNM has been also used in some cases of neurogenic bladder [14,16,28] and also in neurogenic bladder caused by MS, though the few references usually regard a small number of patients and mainly with a short or median follow-up [21][22][23]29]. Furthermore the use of SNM is discouraged in MS for the progressive features of the disease [4] and a limitation to the use of this therapy in MS patients is its contraindication to magnetic resonance (MRI) examination.…”

Section: Discussionmentioning

confidence: 99%

“…Sacral nerve modulation (SNM) is a safe and minimally invasive treatment and it has become an option in refractory low urinary tract symptoms (LUTS) from different underlying diseases [13][14][15][16]; a number of prospective trials and numerous case series have provided an evidence base that has confirmed the efficacy and durability of SNM [17]. Despite the documented clinical benefit, the exact underlying neurophysiological mechanism of action of SNM is complex and not fully Journal of the Neurological Sciences 347 (2014) 257-261 understood.…”

Section: Introductionmentioning

confidence: 99%

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Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction

Andretta

Simeone

Ostardo

et al. 2014

Journal of the Neurological Sciences

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Objective: Bladder dysfunctions are common in multiple sclerosis (MS) often causing the most distressing symptoms. The aim of this paper was to evaluate the effectiveness of sacral nerve modulation (SNM) in this disease. Methods: We conducted an observational retrospective survey in 17 patients treated with SNM in the north-east of Italy, all complaining of bladder symptoms (storage in 41%, voiding in 24%, mixed in 35%) unresponsive to conventional therapies, with a mean follow-up of 52 ± 26 months and mean Expanded Disability Status Scale score of 5.8 ± 1.8. Results: 75% of patients reported significant and lasting improvement in bladder symptoms and in quality of life. We observed a statistically significant improvement in frequency, urgency, number of pads, residual volumes, number of catheterizations and in the voided volumes. In 5 out of 6 cases with mixed symptoms the stimulation was discontinued (device totally explanted or turned off) after a mean time of 66 months (range 10-84 months) after the implant, for disease progression or loss of efficacy. Conclusion: SNM could be an option in very selected cases of storage and voiding symptoms refractory to conservative treatments caused by a stable or slowly progressive MS considering its minimal invasiveness and reversibility. The poor results observed suggest avoiding this therapy in mixed symptoms and in cases of advanced disability.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction

Andretta

Simeone

Ostardo

et al. 2014

Journal of the Neurological Sciences

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“…Sacral neuromodulation (SNM) for the treatment of detrusor disorders has been used since the 1960s and it has been approved by the Food and Drug Administration (FDA) since the 1990s for refractory voiding dysfunction, urgency incontinence, urgency-frequency syndrome and nonobstructive urinary retention [18,19]. SNM has gained popularity as an approach in NDO since the 1980s and in 2005 it was included in treatment recommendations for idiopathic and NDO as a second-line treatment [18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Sacral neuromodulation: an effective treatment for lower urinary tract symptoms in multiple sclerosis

et al. 2015

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“…Moreover, literature reports contrasting results in people with neurogenic bladder dysfunctions, even though the group consists of a restricted number of patients with a short follow-up. 5,6 Nevertheless it has been shown recently that these patients are able to gain remarkable clinical and long-term benefits from SNM. 7 The aim of this study was to evaluate efficacy and complications in a medium and longterm follow-up for partial SCI patients treated with SNM for chronic NLUTS.…”

Section: Introductionmentioning

confidence: 99%

Clinical outcome of sacral neuromodulation in incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms

Lombardi

Popolo

2009

Spinal Cord

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Objective: To determine the efficacy and safety of sacral neuromodulation (SNM) in incomplete spinal cord injured (SCI) subjects affected by neurogenic lower urinary tract symptoms (NLUTS). Methods: Twenty-four SCI patients were enrolled. The individuals were divided into two groups: 13 individuals in the urinary retention category and 11 suffering from overactive bladder syndrome. All subjects underwent definitive SNM implantation (Medtronic, Inc.). Voiding symptoms were assessed using patient bladder diaries, which recorded both pre-SNM and before each follow-up (1, 3 and 6 months, and then every 6 months). Outcome measures were per 24 h: number of voids and voided volume per void for both groups; number of urinary leakages, pad use and nocturia for patients with overactive bladder syndrome; and volume per catheterization and number of catheterizations for urinary retention subjects only. Final checkups were completed by June 2008. Results: Median follow-up was 61 months. Up to the final visit, all subjects maintained a clinical improvement of more than 50% compared with baseline. Twenty-two side effects were recorded. Four subjects with urinary retention needed a new implant in the controlateral S3 sacral root because of loss of efficacy. One patient with urinary retention developed a wound infection at the implanted pulse generator site. Conclusions: Our study contains the largest series of implanted SCI patients ever published. SNM is a therapy to consider in the treatment of NLUTS for partial SCI patients, even if the loss of clinical benefits for patients with retentive NLUTS must be taken into account. All adverse events were treated effectively.

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Sacral nerve neuromodulation in patients with underlying neurologic disease

Cited by 81 publications

References 14 publications

Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction

Usefulness of sacral nerve modulation in a series of multiple sclerosis patients with bladder dysfunction

Sacral neuromodulation: an effective treatment for lower urinary tract symptoms in multiple sclerosis

Clinical outcome of sacral neuromodulation in incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms

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