Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 3 Issue 9

Sacral Nerve Stimulation for Neurogenic Bladder: Our Experience

R Ramnarayan2* and H Krishna Moorthy2

1Consultant Neurosurgeon, New Hope Hospital, Chennai, India
2Consultant Urologist, Lourdes Hospital, Kochi, India

*Corresponding Author: R Ramnarayan, Consultant Neurosurgeon, New Hope Hospital, Chennai, India.

Received: July 24, 2020; Published: August 31, 2020

×

Abstract

Introduction: Neurogenic bladder is a condition causing significant effect on the quality of life of the patient. Sacral nerve stimulation (SNM) has a good role in these patients. We report our experience with sacral neuromodulation.

Methods: 15 patients with refractory urinary bladder were included in this study. The aetiology of the neurogenic bladder included 7 spinal cord injury, 3 meningomyelocele, 2 failed back surgery syndromes, two multiple sclerosis and one mixed bowel/bladder (aetiology unknown). All 15 underwent test stimulation.

Results: Only 10 out the 15 had a positive trial and proceeded to the next stage of implantation. The 3 patients with failed trial were all patients with complete cord injury or injuries below T12 (vertebral level) and more than 8 years duration. Of the other two one was a meningomyelocele and other was a case of advanced multiple sclerosis. Follow up period was upto four years; all 10 patients doing well. One of early cases had lead migration and had to be repositioned. One patient used to develop shock like sensation in perineum; the stimulation was stopped for six weeks and restarted at lower frequency.

Conclusion: SNM is a very effective therapy for neurologic bladder in selected patients. Detailed preoperative assessments and trial are very important in this selection.

Keywords: Sacral Nerve; Neurogenic Bladder; Stimulation; Results

×

References

  1. Thompson JH., et al. “Sacral neuromodulation: Therapy evolution”. Indian Journal of Urology 26 (2010): 379-384.
  2. Ginsberg D. “The epidemiology and pathophysiology of neurogenic bladder”. The American Journal of Managed Care 19 (2013): s191-196.
  3. Campbell UB., et al. “Survey assessment of continuation of and satisfaction with pharmacological treatment for urinary incontinence”. Value Health 11 (2008): 726-732.
  4. Scheepens WA., et al. “Predictive factors for sacral neuromodulation in chronic lower urinary tract dysfunction”. Urology 60 (2002): 598-602.
  5. Health Quality Ontario. “Sacral nerve stimulation for urinary urge incontinence, urgency-frequency, urinary retention, and fecal incontinence: an evidence-based analysis”. Ontario Health Technology Assessment Series 5 (2005): 1-64.
  6. Vignes JR., et al. “Sacral neuromodulation in lower urinary tract dysfunction”. Advances and Technical Standards in Neurosurgery 30 (2005): 177-224.
  7. Sievert KD., et al. “Subcutaneous tunneling of the temporary testing electrode significantly improves the success rate of subchronic sacral nerve modulation”. World Journal of Urology 25 (2007): 607-612.
  8. Scheepens WA., et al. “Unilateral versus bilateral sacral neuromodulation in patients with chronic voiding dysfunction”. The Journal of Urology 168 (2002): 2046-2050.
  9. Seif C., et al. “Findings with Bilateral Sacral Neurostimulation: Sixty-two PNE-Tests in Patients with Neurogenic and Idiopathic Bladder Dysfunctions”. Neuromodulation 7 (2004): 141-145.
  10. Marcelissen T., et al. “Is the screening method of sacral neuromodulation a prognostic factor for long-term success?” The Journal of Urology 185 (2011): 583-587.
  11. Leong RK., et al. “PNE versus 1st stage tined lead procedure: direct comparison to select the most sensitive test method to identify patients suitable for sacral neuromodulation therapy”. Neurourology and Urodynamics 30 (2011): 1249-1252.
  12. Leroi AM., et al. “Outcome and cost analysis of sacral nerve modulation for treating urinary and/or faecal incontinence”. Annals of Surgery 253 (2011): 720-732.
  13. Gahzi AA., et al. “Radiographic Position of the Electrode as a Predictor of the Outcome of InterStim Therapy”. International Neurourology Journal 21 (2017): 289-294.
  14. Lay AH and Das AK. “The role of neuromodulation in patients with neurogenic overactive bladder”. Current Urology Reports 13 (2012): 343-347.
  15. Sukhu T., et al. “Sacral neuromodulation in overactive bladder: a review and current perspectives”. Research and Reports in Urology 8 (2016): 193-199.
  16. Bartley J., et al. “Neuromodulation for overactive bladder”. Nature Reviews Urology 10 (2013): 513-521.
  17. Gani J and Hennessey D. “The underactive bladder: diagnosis and surgical treatment options”. Translational Andrology and Urology 6 (2017): S186-S195.
  18. Mehmood S and Altaweel WM. “Long-term outcome of sacral neuromodulation in patients with idiopathic nonobstructive urinary retention: Single-center experience”. Urology Annals 9 (2017): 244-248.
  19. Cardarelli S., et al. “Efficacy of sacral neuromodulation on urological diseases: a multicentric research project”. Urologia 79 (2012): 90-96.
  20. White WM., et al. “Incidence and predictors of complications with sacral neuromodulation”. Urology 73 (2009): 731-735.
  21. Leong RK., et al. “Satisfaction and patient experience with sacral neuromodulation: results of a single center sample survey”. The Journal of Urology 185 (2011): 588-592.
  22. Chodez M., et al. “Results of sacral nerve neuromodulation for double incontinence in adults”. Techniques in Coloproctology 18 (2014): 1147-1151.
×

Citation

Citation: R Ramnarayan and H Krishna Moorthy. “Sacral Nerve Stimulation for Neurogenic Bladder: Our Experience". Acta Scientific Neurology 3.9 (2020): 112-116.




Metrics

Acceptance rate32%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is April 30th, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US