Unilateral Versus Bilateral Sacral Neuromodulation in Patients With Chronic Voiding Dysfunction

Scheepens, W.A.; Bie, Rob A. de; Weil, E.H.J.; Kerrebroeck, E.V. van

doi:10.1097/00005392-200211000-00035

Cited by 19 publications

(27 citation statements)

References 15 publications

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“…This could be, in part, due to the limited area of stimulation with unilateral S3 stimulation resulting in poor capture of the pain foci. Bilateral stimulation of the S3 nerve root has been performed without good results for most patients; however, a trial of bilateral stimulation in refractory patients has been suggested [9]. Bladder and pelvic pain are bilateral phenomena that involve more than one sacral root; thus, the stimulation of one nerve root or bilateral stimulation at the same level may not alleviate symptoms.…”

Section: Introductionmentioning

confidence: 99%

Short-term results of bilateral S2–S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful baldder syndrome, and chronic pelvic pain

et al. 2007

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We evaluated the efficacy of bilateral caudal epidural sacral neuromodulation for the treatment of refractory chronic pelvic pain (CPP), painful bladder syndrome, and interstitial cystitis (IC). Thirty consecutive patients (21 female, 9 male) with severe refractory symptoms underwent bilateral S2-S4 sacral neuromodulation for CPP/IC. Patients were evaluated with the O'Leary IC symptom and problem index (ICSI, ICPI), the short form of the Urogenital Distress Inventory (UDI-6), and the RAND 36-item health survey (SF-36) preoperatively and 6 months postoperatively. The mean and minimum follow-up were 15 and 6 months, respectively. Of the 30 patients, 23 (77%) had a successful trial stimulation and were permanently implanted. Among these patients, the ICSI and ICPI scores improved by 35 (p = 0.005) and 38% (p = 0.007), respectively. The pain score improved by 40% (p = 0.04) and the UDI-6 score by 26% (p = 0.05). On average, patients reported a 42% improvement in their symptoms. SF-36 scores did not improve significantly. In refractory patients, bilateral caudal epidural sacral neuromodulation is another possible mode of treatment, which appears to improve both pelvic pain and voiding symptoms.

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Section: Introductionmentioning

confidence: 99%

Short-term results of bilateral S2–S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful baldder syndrome, and chronic pelvic pain

et al. 2007

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“…From an initial 456 publications identified by the literature search, 73 articles were included, of which 8 are randomized controlled trials (RCTs) [7][8][9][10][11][12][13][14], 7 are comparative studies [15][16][17][18][19][20][21], 46 are prospective and 10 are retrospective case series [68][69][70][71][72][73][74][75][76][77], and 2 combine prospective and retrospective case series in the same article [78,79]. The screening process is summarized in Fig.…”

Section: Resultsmentioning

confidence: 99%

“…Aside from the 40 articles that investigated implanted SNS, 4 additional studies [17,26,43,61] provided data on percutaneous SNS used either as a test stimulation preliminary to selection for implantation or in a temporary stimulation capacity. These studies, which were published between 1994 and 2006, each included patients with various LUTS.…”

Section: Implanted Sacral Nerve Stimulationmentioning

confidence: 99%

“…Three of these studies focused on the identification of predictors for success of neuromodulation: two using PNE stimulation and one using first-stage stimulation. The fourth study investigated bilateral versus unilateral SNS in a randomized crossover study design [17]. This study did not find a significant difference between bilateral and unilateral stimulation and presented outcome versus baseline voiding parameter data only in graphic form and thus was not included in our analysis.…”

Section: Implanted Sacral Nerve Stimulationmentioning

confidence: 99%

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A systematic review of clinical studies of electrical stimulation for treatment of lower urinary tract dysfunction

2012

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“…L'efficacité d'un tel réglage n'a pas été démontrée ; modifier la fréquence de stimulation entre basse et moyenne fréquence (5 à 30 Hz). Là encore, l'efficacité des modifications de fréquence n'a pas été démontrée ; effectuer un test en controlatéral pour changement de côté de stimulation, voire stimulation bilatérale [42]. Les expériences rapportées chez un petit nombre de patients incontinents anaux ne montrent qu'un bénéfice modeste lors des stimulations contro-ou bilatérales après échappement thérapeutique [3].…”

Section: Pistes D'améliorationunclassified

Stimulation des racines sacrées et incontinence fécale : résultats d’une expérience collective

Leroi

Damon²,

Faucheron

et al. 2008

Pelv Perineol

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Depuis la première publication de Matzel et al., en 1995, rapportant l'efficacité de la stimulation des racines sacrées chez des patients incontinents anaux, les indications, la technique de stimulation ainsi que le suivi des patients implantés ont évolué [1]. Cet article a pour objectif, à partir d'une revue critique de la littérature et au vu des expériences de chacun des experts participants, de proposer une attitude consensuelle pour la prise en charge des patients incontinents anaux par stimulation sacrée. Seront discutées : 1) les indications ; 2) la technique du test temporaire ; 3) la technique de l'implantation ; 4) les modalités de suivi des patients ; 5) la conduite à tenir en cas d'échappement thérapeutique. Nous espérons ainsi offrir aux praticiens intéressés par la stimulation sacrée un guide pour la prise en charge des patients mais également harmoniser nos pratiques, orienter et faciliter les travaux de recherche futurs.Abstract: Since the first paper published by Matzel et al., in 1995, on the efficacy of sacral nerve stimulation in patients with fecal incontinence, the indications, contraindications and stimulation technique used, along with the follow-up of implanted patients, have all changed [1]. The aim of this article is to suggest a consensus of opinion on the management of patients with fecal incontinence by sacral nerve stimulation, based on a critical review of the literature and the experience of each of the participating experts. We will discuss: 1) indications and contraindications; 2) temporary test technique; 3) implantation technique; 4) patient follow-up; 5) approach in case of treatment failure. We hope to provide a guide to patient management for clinical practitioners interested in sacral nerve stimulation, and also to harmonise our practice and orient future research.

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Unilateral Versus Bilateral Sacral Neuromodulation in Patients With Chronic Voiding Dysfunction

Cited by 19 publications

References 15 publications

Short-term results of bilateral S2–S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful baldder syndrome, and chronic pelvic pain

Short-term results of bilateral S2–S4 sacral neuromodulation for the treatment of refractory interstitial cystitis, painful baldder syndrome, and chronic pelvic pain

A systematic review of clinical studies of electrical stimulation for treatment of lower urinary tract dysfunction

Stimulation des racines sacrées et incontinence fécale : résultats d’une expérience collective

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