Sacral neuromodulation - when and for who

Mass-Lindenbaum, Marcelo; Calderón-Pollak, D.; Goldman, Howard B.; Pizarro-Berdichevsky, Javier

doi:10.1590/s1677-5538.ibju.2021.99.08

Cited by 8 publications

(7 citation statements)

References 71 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…After two unsuccessful pudendal nerve blocks and failure of medical therapy (e.g., gabapentin) to provide adequate pain relief, the patient elected to have a sacral neuromodulation (SNM) procedure. SNM is a minimally invasive procedure, which is used to treat bowel and bladder dysfunctions [ 7 ]. The therapeutic technique uses electrical stimulation to sacral nerve roots S3 or S4.…”

Section: Discussionmentioning

confidence: 99%

“…The therapeutic technique uses electrical stimulation to sacral nerve roots S3 or S4. The therapeutic mechanism is not fully understood, but there are currently several working hypotheses, all of which are derived from the SNM possibly modulating the central and peripheral pathways of neural circuits that can override aberrant neural activity [ 7 ]. The mechanism of pain relief is speculated to be due to stimuli transmitted from SNM via Aβ‐fibers interfering with the c-fibers being stimulated by CPP [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Chronic Penile Pain: A Poorly Researched and Managed Life-Debilitating Condition

Huang,

Shah,

Bailon

et al. 2023

Cureus

View full text Add to dashboard Cite

Chronic penile pain is a complex clinical entity with limited diagnostic criteria and treatment options. Due to limited reporting of these cases, there are no clear clinical treatments and indications for when these patients present to the clinic. This case report will highlight the diagnostic challenges encountered and the subsequent management strategies employed while working up a patient with penile pain. We present a 37-year-old male with a six-year history of debilitating penile pain, urinary frequency, and urgency that is exacerbated by sexual arousal and touch. Initial evaluations attributed the symptoms to medication side effects, leading to medication changes. Despite multiple treatments, including gabapentin, solifenacin, vibegron, and a variety of specialist consultations, the patient's condition persisted. Neurological evaluation revealed pudendal neuropathy. Medical management with pudendal nerve blocks and gabapentin did not provide lasting relief, so surgical interventions were considered. Subsequent treatment with an InterStim II device (Medtronic Inc., Minneapolis, MN) initially resulted in significant symptom improvement. Unfortunately, at the seven-month follow-up, his pain returned. Further evaluation and additional treatment options are currently under consideration. This case report highlights the diagnostic complexity and limited treatment options for chronic penile pain. It suggests that sacral neuromodulation, although lacking long-term data, may offer temporary relief in cases refractory to medical therapy. Further research is needed to enhance our understanding and management of this challenging condition.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Chronic Penile Pain: A Poorly Researched and Managed Life-Debilitating Condition

Huang,

Shah,

Bailon

et al. 2023

Cureus

View full text Add to dashboard Cite

show abstract

“…Motor response has to be considered as a tool for correct lead placement: a closer position of the lead to the target nerve guarantees a better motor response at a lower amplitude of stimulation; a higher number of electrodes with good responses enhances the possibility to “reprogram” around a defective electrode to another one that gives therapeutic benefit and reduces the need for surgical revision; and a lower amplitude of stimulation requires less frequent battery changes [ 26 ]. A lower revision rate was demonstrated also in the case of satisfactory big toe motor response due to the stimulation of a more precise and therapeutically significant target nerve compared to perianal motor response [ 27 ]. If the stimulation is regarded as satisfactory by the clinician, the lead is deployed along the S3 root and is connected to an external temporary pulse generator which is left in place during the trial period.…”

Section: Surgical Aspectsmentioning

confidence: 99%

Sacral Neuromodulation: Device Improvement and Current Applications in Urology

Spilotros,

Gerbasi,

Lasorsa

et al. 2024

Medicina

View full text Add to dashboard Cite

Sacral neuromodulation (SNM) offers a therapeutic approach to urological patients suffering from idiopathic overactive bladder (OAB) syndrome, with or without incontinence and non-obstructive urinary retention (NOR), who are not responding to or are not compliant with conservative or medical therapies. The exact mechanism of action of SNM is not fully understood but modulation of the spinal cord reflexes and brain networks by peripheral afferents is regarded as the main pathway. Over the years, surgical techniques improved, leading to the development of the modern two-stage implantation technique. The quadripolar lead is positioned percutaneously under fluoroscopy guidance through the third sacral foramen following the trajectory of S3. The procedure can be performed under local or general anesthesia with the patient in prone position. Current applications of sacral neuromodulation in urology are increasing thanks to the recent improvements of the devices that make this a valuable option not only in conditions such as overactive bladder and non-obstructing urinary retention but also neurogenic lower urinary tract dysfunction.

show abstract

“…(7) In the case of FI, the diagnosis is clinical, and the American Society of Colon and Rectal Surgeons (ASCRS) states that after failing biofeedback, the next option is neuromodulation in the absence of recent sphincter damage. (8) SNM involves the implantation of a pulse generator or IPG (Implantable Pulse Generator) connected to a quadripolar electrode to stimulate the sacral roots. The available IPG battery in our country (InterStim II™) lasts 4-6 years.…”

Section: Introductionmentioning

confidence: 99%

Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital

Mass-Lindenbaum,

Arévalo-Vega,

Aleuanlli

et al. 2024

Revista Brasileira De Ginecologia E Obstetrícia / RBGO Gynecology and Obstetrics

Self Cite

View full text Add to dashboard Cite

Objective: To show the experience of a Latin American public hospital, with SNM in the management of either OAB, NOUR or FI, reporting feasibility, short to medium-term success rates, and complications.Methods: A retrospective cohort was conducted using data collected prospectively from patients with urogynecological conditions and referred from colorectal surgery and urology services between 2015 and 2022.Results: Advanced or basic trial phases were performed on 35 patients, 33 (94%) of which were successful and opted to move on Implantable Pulse Generator (GG) implantation. The average

show abstract

Sacral neuromodulation - when and for who

Cited by 8 publications

References 71 publications

Chronic Penile Pain: A Poorly Researched and Managed Life-Debilitating Condition

Chronic Penile Pain: A Poorly Researched and Managed Life-Debilitating Condition

Sacral Neuromodulation: Device Improvement and Current Applications in Urology

Sacral neuromodulation therapy for urinary and defecatory disorders: experience in a Latin American public hospital

Contact Info

Product

Resources

About