Sacral Neuromodulation in Lower Urinary Tract Dysfunction

Vignes, Jean‐Rodolphe; Sèze, M. de; Dobremez, E.; Joseph, Pierre-Alain; Guérin, J.

doi:10.1007/3-211-27208-9_5

Cited by 15 publications

(5 citation statements)

References 137 publications

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“…The mechanisms for the efficacy of neuromodulation for voiding dysfunction are not completely understood, but this approach can substantially improve the quality of life for patients who are refractory to traditional pharmacologic therapy. 1 Neuromodulation of the sacral nerves has been used for treatment of chronic pelvic pain as well, but with less evidence for efficacy. Sacral nerve stimulation also has a role in treatment of chronic pelvic pain in which spinal cord stimulation may not be effective.…”

Section: Introductionmentioning

confidence: 99%

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Mayer

Howard

2008

Neurotherapeutics

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Summary:Voiding dysfunction, which includes incontinence, retention, and chronic pelvic pain, is a relatively frequent problem that can be difficult to manage. Neuromodulation via stimulation of the sacral nerves has been shown to improve thesesymptoms, although the exact mechanisms remain elusive. Techniques for nerve stimulation may vary, depending on the disease, location of pain, and the patient's anatomy. In addition to placement of electrodes on the sacral nerve roots, modulation has also been reported by peripheral branches of the sacral nerves including the pudendal and posterior tibial nerves. Newer surgical techniques have significantly decreased the morbidity of the procedures and increased the probability of a successful outcome.

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Section: Introductionmentioning

confidence: 99%

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Mayer

Howard

2008

Neurotherapeutics

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“…During micturition, sympathetic motor neurons are suppressed and parasympathetic motor neurons are activated. PMC neurons directly activate parasympathetic preganglionic motor neurons, causing bladder contraction and sustained relaxation of the urethral sphincter [ 22 ]. vl-PAG is important for controlling micturition through both afferent and efferent pathways.…”

Section: Discussionmentioning

confidence: 99%

Add-on Therapy With the α-Blockers Tamsulosin and Naftopidil Improves Voiding Function by Enhancing Neuronal Activity in Prostatic Hyperplasia Rats

Hwang

Jin

et al. 2018

Int Neurourol J

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PurposeBenign prostatic hyperplasia (BPH) impacts quality of life in men by causing lower urinary tract symptoms. α1-Adrenoceptor (α1-AR) blockers improve lower urinary tract symptoms. We investigated the efficacy of add-on therapy with α1-AR blockers on BPH rats.MethodsRats in the drug-treated groups were orally administered each drug once a day for 30 days after orchiectomy. To induce BPH, rats were castrated and testosterone (20 mg/kg) was injected subcutaneously once per day for 30 days. Cystometry was conducted to measure voiding contraction pressure and the interval contraction time, immunohistochemistry was performed to measure c-Fos and nerve growth factor (NGF) expression in the neuronal voiding centers, and nicotinamide adenine dinucleotide phosphate-diaphorase histochemistry was used to measure nitric oxide synthase (NOS) expression.ResultsOrchiectomy and testosterone injection decreased voiding contraction pressure and the interval contraction time, suggesting BPH symptoms. Voiding contraction pressure and the interval contraction time were greater in the group that received the combination treatment (tamsulosin with naftopidil) than in the tamsulosin monotherapy or naftopidil monotherapy groups. c-Fos, NGF, and NOS expression in the neuronal voiding centers was enhanced by BPH induction. c-Fos, NGF, and NOS expression was suppressed by the combination treatment (tamsulosin with naftopidil) to a greater extent than was the case for tamsulosin monotherapy or naftopidil monotherapy.ConclusionsCombination therapy of tamsulosin and naftopidil showed greater efficacy for the treatment of BPH than tamsulosin monotherapy or naftopidil monotherapy; therefore, combination therapy can be considered as a novel therapeutic method for BPH.

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“…During micturition, suppression of the sympathetic motor neurons and activation of the parasympathetic motor neurons occur. PMC neurons directly activate the parasympathetic preganglionic motor neurons causing bladder contraction and sustained relaxation of the urethral sphincter [15,17]. vlPAG is a central region in the controlling micturition through both afferent and efferent pathways.…”

Section: Discussionmentioning

confidence: 99%

Effects of Combination Treatment of Alpha 1-Adrenergic Receptor Antagonists on Voiding Dysfunction: Study on Target Organs in Overactive Bladder Rats

Moon

Kim

et al. 2016

Int Neurourol J

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PurposeOveractive bladder (OAB) causes urinary urgency, usually accompanied by frequency and nocturia. Alpha 1-adrenergic receptor (α1-AR) antagonists are known to improve lower urinary tract symptoms associated with OAB. The α1-AR antagonists constitute a variety of drugs according to the receptor subtype affinity. This study investigated the efficacy of tamsulosin, naftopidil, and a combination of the two on OAB rats.MethodsThe OAB rat model was induced by an intraperitoneal injection of cyclophosphamide for 14 days. The experimental groups were divided into 5 groups: control group, OAB-induction group, OAB-induction and tamsulosin monotherapy group, OAB-induction and naftopidil monotherapy group, and OAB-induction and tamsulosin-naftopidil combination therapy group. For the drug-treated groups, each drug was administrated for 14 days after the OAB induction. Cystometry for urodynamic evaluation and immunohistochemical stain for c-Fos and nerve growth factor (NGF) expressions in the central micturition centers were performed.ResultsIncreased contraction pressure and time with enhanced c-Fos and NGF expressions in the central micturition centers were found in the OAB rats. Tamsulosin suppressed contraction pressure and time while inhibiting c-Fos and NGF expressions. Naftopidil showed no significant effect and combination therapy showed less of an effect on contraction pressure and time. Naftopidil and combination therapy exerted no significant effect on the c-Fos and NGF expressions.ConclusionsTamsulosin showed the most prominent efficacy for the treatment of OAB compared to the naftopidil and combination. The combination of tamsulosin with naftopidil showed no synergistic effects on OAB; however, further studies of addon therapy might provide opportunities to find a new modality.

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Sacral Neuromodulation in Lower Urinary Tract Dysfunction

Cited by 15 publications

References 137 publications

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Add-on Therapy With the α-Blockers Tamsulosin and Naftopidil Improves Voiding Function by Enhancing Neuronal Activity in Prostatic Hyperplasia Rats

Effects of Combination Treatment of Alpha 1-Adrenergic Receptor Antagonists on Voiding Dysfunction: Study on Target Organs in Overactive Bladder Rats

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