Search results for "Sacral nerve"

Sacral neurostimulation and neuromodulation in urological practice

2000

The problems associated with treating various forms of lower tract dysfunction by electrical stimulation are reflected in the many years of basic and clinical research in this area. However, better understanding of both neuroanatomy and neurophysiology, and development of new technologies have led to further application of electrical current to restore impaired bladder function. Contemporary knowledge of the potential for both sacral neurostimulation and neuromodulation as a therapeutic option for lower urinary tract dysfunction is reviewed.

The laparoscopic implantation of neuroprothesis (LION) procedure to control intractable abdomino-pelvic neuralgia

2011

Objective. To present different aspects and advantages of the laparoscopic implantation of a peripheral nerve stimulator adjacent to the pelvic nerves, aimed at treating intractable pelvic neuralgia by means of neuromodulation - the laparoscopic implantation of neuroprothesis (LION) procedure. Materials and Methods. We report here a series of three patients with different types and etiologies of chronic pelvic neuralgia who underwent laparoscopy for implantation of a peripheral nerve stimulator for neuromodulation, the first for neuromodulation of the ilioinguinal and pudendal nerves, the second for neuromodulation of the sciatic nerve, and the third for neuromodulation of the sacral nerve …

Anatomy of the Sacral Roots and the Pelvic Splanchnic Nerves in Women Using the LANN Technique

2007

AIMS: To report on our anatomic and electrophysiologic findings about the sacral nerve roots and the pelvic splanchnic nerves during laparoscopic pelvic surgery. METHODS: The pelvic splanchnic nerves and the sacral nerve roots were dissected in 336 consecutive patients undergoing laparoscopy for pelvic pain syndrome or gynecologic diseases. Intraoperative assessment of the functionality of the exposed nerves was performed using the LAparoscopic Neuro-Navigation (LANN) technique. RESULTS: Dissection of the sacral roots and the splanchnic pelvic nerves lateral to the sacral hypogastric fascia was feasible without any complications in all patients in this series. The mean surgical time was 16 …

Transcutaneous sacral nerve stimulation for intraoperative verification of internal anal sphincter innervation.

2017

Background: The current standard for pelvic intraoperative neuromonitoring (pIONM) is based on intermittent direct nerve stimulation. This study investigated the potential use of transcutaneous sacral nerve stimulation for non‐invasive verification of pelvic autonomic nerves. Methods: A consecutive series of six pigs underwent low anterior rectal resection. For transcutaneous sacral nerve stimulation, an array of ten electrodes (cathodes) was placed over the sacral foramina (S2 to S4). Anodes were applied on the back, right and left thigh, lower abdomen, and intra‐anally. Stimulation using the novel method and current standard were performed at different phases of the experiment…

Sacral neuromodulation for treatment of lower urinary tract dysfunction

2000

Despite initial reservations, sacral neuromodulation has begun to develop as a new therapeutic tool for the treatment of lower urinary tract dysfunction. It bridges the gap between conservative treatment options and highly invasive procedures, such as urinary diversion. At present, there are no clinical variables that can reliably predict the efficacy of neuromodulation in an individual patient. All patients, regardless of indication, must therefore undergo a test stimulation before they can be offered chronic sacral neuromodulation with an implanted system. Evaluations in various clinical trials have confirmed that sacral neuromodulation, based on unilateral sacral foramen electrode implan…

Chronic sacral neuromodulation for treatment of neurogenic bladder dysfunction: long-term results with unilateral implants

2001

Abstract Objectives. To investigate the therapeutic value of sacral neuromodulation in patients with neurogenic disorders in whom conservative treatment options were unsuccessful. Neurogenic disorders may result in various forms of lower urinary tract dysfunction. Methods. Twenty-seven patients (19 women, 8 men) aged 18 to 63 years (mean 44.9 years) were subjected to percutaneous test stimulation of the sacral spinal nerves. Their urologic symptoms consisted of bladder storage failure (n = 15) due to detrusor hyperreflexia and/or bladder hypersensitivity, failure to empty due to detrusor areflexia (n = 11), and combined bladder hypersensitivity and detrusor areflexia (n = 1). Twelve patient…

Extracorporeal Stimulation of Sacral Nerve Roots for Observation of Pelvic Autonomic Nerve Integrity: Description of a Novel Methodological Setup.

2017

Introduction: Neurophysiologic monitoring can improve autonomic nerve sparing during critical phases of rectal cancer surgery. Objectives: To develop a system for extracorporeal stimulation of sacral nerve roots. Methods: Dedicated software controlled a ten-electrode stimulation array by switching between different electrode configurations and current levels. A built-in impedance and current level measurement assessed the effectiveness of current injection. Intra-anal surface electromyography (sEMG) informed on targeting the sacral nerve roots. All tests were performed on five pig specimens. Results: During switching between electrode configurations, the system delivered 100% of the set cur…

Re: Outcomes of Lumbar to Sacral Nerve Rerouting for Spina Bifida

2011

Efficacy and acceptance of the sacral neuromodulation in the treatment of female lower urinary tract dysfunctions.

2017

Management of urinary incontinence in postmenopausal women: An EMAS clinical guide.

2020

INTRODUCTION: The prevalence of urinary incontinence and of other lower urinary tract symptoms increases after the menopause and affects between 38 % and 55 % of women aged over 60 years. While urinary incontinence has a profound impact on quality of life, few affected women seek care. AIM: The aim of this clinical guide is to provide an evidence-based approach to the management of urinary incontinence in postmenopausal women. MATERIALS AND METHODS: Literature review and consensus of expert opinion. SUMMARY RECOMMENDATIONS: Healthcare professionals should consider urinary incontinence a clinical priority and develop appropriate diagnostic skills. They should be able to identify and manage a…