Sacral Nerve Stimulation for Treatment of Refractory Urinary Urge Incontinence

Schmidt, Richard A.; Jonas, Udo; Oleson, Kimberly A.; JANKNEGT, RUUD A.; Hassouna, Magdy; Siegel, Steven; Kerrebroeck, Philip E. V. A. Van

doi:10.1097/00005392-199908000-00018

Cited by 76 publications

(104 citation statements)

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“…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%

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: 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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“…Intention to treat analysis demonstrated a 61% success rate for neuromodulation and 42% success for standard medical treatment at 6 months of treatment. In another prospective randomized study, over 6 months, 34 implanted patients were observed and 42 patients, who received standard medical therapy, comprised the control group [32]. Voiding and incontinence parameters were significantly better in the SNM group compared with the control group with 76% success, including 47% completely without incontinence.…”

Section: Oab With or Without Urinary Incontinencementioning

confidence: 99%

Sacral Neuromodulation for the Treatment of Urinary Bladder Dysfunction: Mechanism of Action and Future Directions

Blok

2017

Bioelectron. Med.

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Symptoms of overactive bladder affect a large portion of the world population, especially the elderly. Sacral neuromodulation (SNM) is an effective third-line therapy in patients with overactive bladder. The working mechanism of SNM can be explained by the neural connections of the lower urinary tract. It is proposed that SNM does not work directly on the central components of the micturition reflex, but on cortical and subcortical areas, which in turn inhibits the micturition reflex components in the caudal brainstem. The clinical use and outcomes of SNM are described for several forms of bladder dysfunction. Furthermore, some recent new developments in SNM are discussed, such as expanded indications, more effective use of existing nonrechargeable neuromodulators and the introduction of a rechargeable device. Conservative treatment of overactive bladder (OAB) with or without urinary incontinence consists of pelvic floor exercises, medication and lifestyle intervention, including fluid restriction and timely voiding. If these conservative interventions fail, it is possible to offer electrical stimulation therapies, such as sacral neuromodulation (SNM). In patients suffering from urinary urgency, frequency and urgency incontinence, electrical stimulation of the sacral nerve significantly reduces urinary symptoms and improves patient quality of life. SNM is also used effectively for other forms of bladder dysfunction, such as underactive bladder and bladder pain syndrome (BPS). The increased use of minimally invasive SNM has decreased the need for more open surgical procedures such as ileocystoplasty and urinary diversion. SNM uses an implanted electrode to the third or fourth sacral spinal nerve to deliver a nonpainful electrical stimulus. The brain of the patient perceives this stimulus and, in turn, effectively restores bladder function and alleviates the patients' symptoms. Due to the system-oriented, and not organ-oriented, approach, SNM not only treats urinary disorders, but may also have a beneficial effect on bowel and sexual dysfunction as well as on pelvic pain. Normal control of the lower urinary tractIn order to understand the role of the brain in the control of the urinary bladder and its sphincter, one can make a distinction between structures and axonal tracts in the caudal brainstem and spinal cord, which are intrinsic part of the micturition and continence reflex, and structures and pathways, located in the forebrain and mesencephalon, which modulate these micturition and continence areas. Most of the clinical therapies aimed at functional bladder disorders are not specifically targeted to the micturition reflex areas, but influence cortical and subcortical brain areas, which, in turn, modulate the micturition reflex components. Examples of such therapies are pelvic floor physiotherapy, biofeedback, transcutaneous electrical nerve stimulation, posterior tibial nerve stimulation and SNM. Currently, there is no effective behavioral, chemical or electrical treatment which works directly and specifica...

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“…В 1999 г. R. A. Schmidt и соавт. показали возможность применения стимуля-ции сакральных корешков для лечения ИНМ [19]. В 2000 г. T. Fujishiro и соавт.…”

Section: том 7 Volunclassified

Peripheral repetitive magnetic stimulation for the treatment of neurogenic urinary disorders: literature review and investigational study

Borodulina¹,

Rachin²,

Бадалов³

et al. 2017

Neuromuscular Diseases

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ТОМ 7 VOL. 7Нервно-мышечные Б О Л Е З Н И Neuromuscular DISEASES 54 Оригинальные исследованияВведение Возможности терапевтического применения энер-гии магнитного поля -предмет практического инте-реса на протяжении нескольких столетий. Начало этому пути положили эксперименты Л. Гальвани, ко-торый в XVIII веке сформулировал теорию животного электричества и создал базу для развития электрофи-зиологии. С этого времени началось более глубокое изучение электромагнитного взаимодействия. Откры-тие явления электромагнитной индукции М. Фараде-ем в середине XIX века позволило установить, что в от-вет на переменное магнитное поле (ПМП) в проводящей среде возникает электрический ток. На этом постулате физики в последующем базировал-ся механизм воздействия магнитного импульса на жи-вую ткань. В противоположность электрической сти-муляции

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Sacral Nerve Stimulation for Treatment of Refractory Urinary Urge Incontinence

Abstract: Sacral nerve stimulation is safe and effective in treating refractory urinary urge incontinence.

Cited by 76 publications

References 0 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 for the Treatment of Urinary Bladder Dysfunction: Mechanism of Action and Future Directions

Peripheral repetitive magnetic stimulation for the treatment of neurogenic urinary disorders: literature review and investigational study

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