The effects of bilateral caudal epidural S2–4 neuromodulation on female sexual function

Zabihi, Nasim; Mourtzinos, Arthur; Maher, Mary Grey; Raz, Shlomo; Rodríguez, Larissa V.

doi:10.1007/s00192-007-0504-8

Cited by 34 publications

(18 citation statements)

References 10 publications

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“…The permanent InterStim® implant has been shown to provide benefit to those suffering from refractory overactive bladder and retention. Early reports have shown that InterStim® neuromodulation may also provide benefit for women with female sexual dysfunction …”

Section: Introductionmentioning

confidence: 99%

The effect of sacral neuromodulation on pudendal nerve function and female sexual function

Parnell

Howard

Geller

2014

Neurourology and Urodynamics

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Section: Introductionmentioning

confidence: 99%

The effect of sacral neuromodulation on pudendal nerve function and female sexual function

Parnell

Howard

Geller

2014

Neurourology and Urodynamics

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“…Another study on the effects of SNM for LUTS on female sexual function was carried out by Zahibi et al [24]. A characteristic of this study was that a large proportion of the patients had pelvic pain as well as LUTS.…”

Section: Discussionmentioning

confidence: 99%

Sexual Response in Patients Treated with Sacral Neuromodulation for Lower Urinary Tract Symptoms or Fecal Incontinence

Voskuilen¹,

Oerlemans²,

Gielen

et al. 2012

Urol Int

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Objectives: To determine whether sacral neuromodulation (SNM) for urinary symptoms or fecal incontinence gives improvement of female sexual function and whether improvement is due to physiological or psychological factors. Methods: Between 2002 and 2008, 8 patients had an array of questionnaires before and after SNM implantation. The questionnaires were: the Questionnaire for Screening for Sexual Dysfunctions, the Golombok Rust Inventory of Sexual Satisfaction, the Symptom Checklist-90, the Maudsley Marital Questionnaire and the McGill-Mah Orgasm Questionnaire. Three of these 8 patients underwent vaginal plethysmography before and after implantation. Results: No statistically significant changes were found, although there seems to be a trend toward improvement in orgasm scores. In plethysmography all 3 patients showed increased vaginal pulse amplitude with the stimulator turned on with both erotic and non-erotic stimuli. Conclusions: This study does not show a clear effect of SNM on sexual function, although there seems to be an improvement in orgasm scores. The lack of response on psychological questionnaires and the increase in vaginal pulse amplitude after SNM implantation indicate that there might be a physiological response.

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“…However, one attractive hypothesis is that widespread activation of both ascending and descending activity in the spinal cord may strengthen synaptic activity in lumbosacral motor centers through Hebbian mechanisms, including walking, micturition, and defecation. Recent unconfirmed reports (46,123,170,278) suggest epidural stimulation may improve sexual function, another programmed activity of the lower spinal cord. If confirmed, epidural stimulation is likely to become a popular approach for this purpose.…”

Section: Epidural Spinal Cord Stimulationmentioning

confidence: 98%

Electrical Stimulation and Motor Recovery

Young

2015

Cell Transplant

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In recent years, several investigators have successfully regenerated axons in animal spinal cords without locomotor recovery. One explanation is that the animals were not trained to use the regenerated connections. Intensive locomotor training improves walking recovery after spinal cord injury (SCI) in people, and >90% of people with incomplete SCI recover walking with training. Although the optimal timing, duration, intensity, and type of locomotor training are still controversial, many investigators have reported beneficial effects of training on locomotor function. The mechanisms by which training improves recovery are not clear, but an attractive theory is available. In 1949, Donald Hebb proposed a famous rule that has been paraphrased as "neurons that fire together, wire together." This rule provided a theoretical basis for a widely accepted theory that homosynaptic and heterosynaptic activity facilitate synaptic formation and consolidation. In addition, the lumbar spinal cord has a locomotor center, called the central pattern generator (CPG), which can be activated nonspecifically with electrical stimulation or neurotransmitters to produce walking. The CPG is an obvious target to reconnect after SCI. Stimulating motor cortex, spinal cord, or peripheral nerves can modulate lumbar spinal cord excitability. Motor cortex stimulation causes long-term changes in spinal reflexes and synapses, increases sprouting of the corticospinal tract, and restores skilled forelimb function in rats. Long used to treat chronic pain, motor cortex stimuli modify lumbar spinal network excitability and improve lower extremity motor scores in humans. Similarly, epidural spinal cord stimulation has long been used to treat pain and spasticity. Subthreshold epidural stimulation reduces the threshold for locomotor activity. In 2011, Harkema et al. reported lumbosacral epidural stimulation restores motor control in chronic motor complete patients. Peripheral nerve or functional electrical stimulation (FES) has long been used to activate sacral nerves to treat bladder and pelvic dysfunction and to augment motor function. In theory, FES should facilitate synaptic formation and motor recovery after regenerative therapies. Upcoming clinical trials provide unique opportunities to test the theory. INTRODUCTIONIn the past decade, several prominent laboratories have shown axonal regeneration in animal spinal cord injury (SCI) models, but locomotor recovery did not follow regeneration (277). For example Lu et al. (159,160) and He's group (156,282) regenerated many axons that synapsed with neurons in the lower spinal cord, but the animals did not recover walking. To explain the lack of locomotor recovery, the investigators assume that insufficient numbers of regenerated axons have formed synapses with appropriate neurons in the lower spinal cord to support locomotion. Another explanation for the lack of locomotor recovery after complete SCI and regeneration is that the animals did not learn to use their newly regrown connections.Regenerated fibe...

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The effects of bilateral caudal epidural S2–4 neuromodulation on female sexual function

Cited by 34 publications

References 10 publications

The effect of sacral neuromodulation on pudendal nerve function and female sexual function

The effect of sacral neuromodulation on pudendal nerve function and female sexual function

Sexual Response in Patients Treated with Sacral Neuromodulation for Lower Urinary Tract Symptoms or Fecal Incontinence

Electrical Stimulation and Motor Recovery

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