Continuous Stimulation of Sacral Roots in the Treatment of Urinary Pathologies and Fecal: Clinical Evaluation of a Series of 18 Patients Implanted
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May 10, 2013
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Abstract
Introduction: Sphincter control pathologies undermine the Quality of Life (QoL).
Objectives: To assess the results of the treatment with sacral nerve stimulation in patients with urinary and fecal incontinence and with sexual dysfunction.
Results: From 2007 to 2012, electrodes were implanted in 18 patients for sacral nerve stimulation (6 had urge urinary incontinence; 4, mixed incontinence; 4, urgency frequency incontinence; 2, urinary retention; 2, fecal incontinence, and 1, retrograde ejaculation). We assess records of urinary or fecal leakage and questionnaires on QoL.
Conclusions: The best results were presented by the urgency frequency patients (they all improved), by the fecal incontinence group and it amazes the good results obtained by the patient with retrograde ejaculation. In conclusion, sacral nerve stimulation is an effective technique for the treatment of illnesses that produce urinary or fecal incontinence obtaining an improvement of QoL over 50 %.
Keywords
plexo lumbosacro, incontinencia urinaria, incontinencia fecal, calidad de vida, Sacral nerve, urinary incontinence, fecal incontinence, quality of life,
References
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11. Mowatt G, Glazener C, Jarrett M. Sacral nerve stimulation for fecal incontinence and constipation in adults: A short version Cochrane review. Neurourol Urodyn. 2008;27(3):155-61.
12. Norderval S, Rydningen M, Lindsetmo RO, Lein D, Vonen B. Sacral nerve stimulation. Tidsskrift for Den Norske Laegeforening. 2011;131(12):1190-3.
13. Peeren F, Hoebeke P, Everaert K. Sacral nerve stimulation: Interstim therapy. Expert Rev Med Devices. 2005;2(3):253-8.
14. Rittenmeyer H. Sacral nerve neuromodulation (InterStim). Part I: Review of the InterStim system. Urol Nurs. 2008;28(1):15-20.
15. Rittenmeyer H. Sacral nerve neuromodulation (InterStim). Part II: Review of programming. Urol Nurs. 2008;28(1):21-5.
16. Rittenmeyer H. Sacral nerve neuromodulation (InterStim). Part III: Case studies. Urol Nurs. 2008;28(1):26-8.
17. Van Kerrebroeck PE, van Voskuilen AC, Heesakkers JP, et al. Results of sacral neuromodulation therapy for urinary voiding dysfunction: Outcomes of a prospective, worldwide clinical study. J Urol. 2007;178(5):2029-34.
18. Yakovlev AE, Resch BE. Treatment of urinary voiding dysfunction syndromes with spinal cord stimulation. Clin Med Res. 2010;8(1):22-4.
19. Bradley WE, Timm GW, Chou SN. A decade of experience with electronic stimulation of the micturition reflex. Urol Int. 1971;26:283.
20. Caldwell KPS. Urinary incontinence following spinal injury treated by electronic implant. Lancet. 1985;1:846.
21. Dunitz M, Jonas U, Grunewald V. New perspectives in sacral nerve stimulation for control of lower urinary tract dysfunction. Londres: s. e.; 2002.
22. Brazier MAB. A history of neurophysiology in the 17th and 18th Centuries. New York: Raven Press; 1984.
23. Franco I. Overactive bladder in children. Part 1: Pathophysiology. J Urol. 2007;178:761-8.
24. Kwon C, Sand PK. Management of overactive bladder and urinary tract infections in women. New York: McMahon Publishing Group; 2003.
25. Apostolidis A. Neuromodulation for intractable OAB. Neurourol Urodyn. 2011;30(5):766-70.
26. Franco I. The central nervous system and its role in bowel and bladder control. Current Urol Reports. 2011;12:153-7.
27. Roberts M, Jarvi K. Steps in the investigation and management of low semen volume in the infertile man. Can Urol Assoc J. 2009;3(6):479-85.
28. Bennet CJ, Seager SW, Vasher EA, et al. Sexual dysfunction and electroejaculation in men with spinal cord injury: review. J Urol. 1988;139:453-7.
29. Tanagho EA, Schmidt RA. Electrical stimulation in the clinical management of the neurogenic bladder. J Urol. 1988;140:1331-9.
30. Hashin H, Abrams P. Overactive bladder: un update. Curr Opin Urol. 2007;17:231-6.
31. Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed?: A population-based prevalence study. Br J Urol Int. 2001;87:760.
32. Stewart W, Herzog AR, Wein A, et al. Prevalence and impact of overactive bladder in the US: Results from the NOBLE program. Neurourol Urodyn. 2001;20:406.
2. Parsons M, Cardozo L. The classification of urinary incontinence. Reviews in Gynaecological Practice. 2003;3:57-64.
3. Brazzelli M, Murray A, Fraser C. Efficacy and safety of sacral nerve stimulation for urinary urge incontinence: A systematic review. J Urology. 2006;175 (3 Pt 1):835-41.
4. Health Quality Ontario. Sacral nerve stimulation for urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence: An evidence-based analysis. Ont Health Technol Assess Ser. 2005;5(3):1-64.
5. Butrick CW. Patient selection for sacral nerve stimulation. Int Urogynecol J. 2010;21 Suppl 2: S447-51.
6. Chartier-Kastler E. Sacral neuromodulation for treating the symptoms of overactive bladder syndrome and nonobstructive urinary retention: >10 years of clinical experience. BJU International. 2008;101(4):417-23.
7. Dudding TC. Future indications for sacral nerve stimulation. Colorectal Dis. 2011;13 Suppl 2: 23-8.
8. Herbison GP, Arnold EP. Sacral neuromodulation with implanted devices for urinary storage and voiding dysfunction in adults. Cochrane Database Syst Rev. 2009;(2) CD004202.
9. Hoda MR, Fornara P. Sacral neuromodulation in urology: The emperor’s new clothes or effective high-tech medicine? Der Urologe. 2010;49(10):1254-9.
10. Leroi AM. The role of sacral neuromodulation in double incontinence. Colorectal Dis. 2011;13 Suppl 2:15-8.
11. Mowatt G, Glazener C, Jarrett M. Sacral nerve stimulation for fecal incontinence and constipation in adults: A short version Cochrane review. Neurourol Urodyn. 2008;27(3):155-61.
12. Norderval S, Rydningen M, Lindsetmo RO, Lein D, Vonen B. Sacral nerve stimulation. Tidsskrift for Den Norske Laegeforening. 2011;131(12):1190-3.
13. Peeren F, Hoebeke P, Everaert K. Sacral nerve stimulation: Interstim therapy. Expert Rev Med Devices. 2005;2(3):253-8.
14. Rittenmeyer H. Sacral nerve neuromodulation (InterStim). Part I: Review of the InterStim system. Urol Nurs. 2008;28(1):15-20.
15. Rittenmeyer H. Sacral nerve neuromodulation (InterStim). Part II: Review of programming. Urol Nurs. 2008;28(1):21-5.
16. Rittenmeyer H. Sacral nerve neuromodulation (InterStim). Part III: Case studies. Urol Nurs. 2008;28(1):26-8.
17. Van Kerrebroeck PE, van Voskuilen AC, Heesakkers JP, et al. Results of sacral neuromodulation therapy for urinary voiding dysfunction: Outcomes of a prospective, worldwide clinical study. J Urol. 2007;178(5):2029-34.
18. Yakovlev AE, Resch BE. Treatment of urinary voiding dysfunction syndromes with spinal cord stimulation. Clin Med Res. 2010;8(1):22-4.
19. Bradley WE, Timm GW, Chou SN. A decade of experience with electronic stimulation of the micturition reflex. Urol Int. 1971;26:283.
20. Caldwell KPS. Urinary incontinence following spinal injury treated by electronic implant. Lancet. 1985;1:846.
21. Dunitz M, Jonas U, Grunewald V. New perspectives in sacral nerve stimulation for control of lower urinary tract dysfunction. Londres: s. e.; 2002.
22. Brazier MAB. A history of neurophysiology in the 17th and 18th Centuries. New York: Raven Press; 1984.
23. Franco I. Overactive bladder in children. Part 1: Pathophysiology. J Urol. 2007;178:761-8.
24. Kwon C, Sand PK. Management of overactive bladder and urinary tract infections in women. New York: McMahon Publishing Group; 2003.
25. Apostolidis A. Neuromodulation for intractable OAB. Neurourol Urodyn. 2011;30(5):766-70.
26. Franco I. The central nervous system and its role in bowel and bladder control. Current Urol Reports. 2011;12:153-7.
27. Roberts M, Jarvi K. Steps in the investigation and management of low semen volume in the infertile man. Can Urol Assoc J. 2009;3(6):479-85.
28. Bennet CJ, Seager SW, Vasher EA, et al. Sexual dysfunction and electroejaculation in men with spinal cord injury: review. J Urol. 1988;139:453-7.
29. Tanagho EA, Schmidt RA. Electrical stimulation in the clinical management of the neurogenic bladder. J Urol. 1988;140:1331-9.
30. Hashin H, Abrams P. Overactive bladder: un update. Curr Opin Urol. 2007;17:231-6.
31. Milsom I, Abrams P, Cardozo L, et al. How widespread are the symptoms of an overactive bladder and how are they managed?: A population-based prevalence study. Br J Urol Int. 2001;87:760.
32. Stewart W, Herzog AR, Wein A, et al. Prevalence and impact of overactive bladder in the US: Results from the NOBLE program. Neurourol Urodyn. 2001;20:406.
How to Cite
Acevedo González, J. C., Becerra, J. E., Silva, J. M., Berbeo, M. E., Feo Lee, Óscar, Zorro, Óscar, & Díaz, R. (2013). Continuous Stimulation of Sacral Roots in the Treatment of Urinary Pathologies and Fecal: Clinical Evaluation of a Series of 18 Patients Implanted. Universitas Medica, 54(4), 419–442. https://doi.org/10.11144/Javeriana.umed54-4.ecrs
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