Literature DB >> 22154635

A modified approach to patient's selection with improved clinical outcomes in sacral nerve modulation.

Patrick Richard1, Maude Carmel, Bechir Hage, Sophie Ramsay, Le Mai Tu.   

Abstract

INTRODUCTION: Since the marketing of the percutaneous permanent tined leads (PPTL), many centres rely solely on these instead of the percutaneous nerve evaluation (PNE) as a screening tool. At our centre, we routinely perform PNE. Moreover, with our limited hospital resources, we have adopted a stricter definition of success in the patient selection process using an improvement of more than 60% as a cut-off point. This study presents our experience with sacral nerve stimulation using PPTL as an adjunct to PNE to improve the outcome of the screening method for patients suffering from refractory voiding dysfunction.
METHODS: We reviewed the charts of 106 patients who underwent a PNE between 2001 and 2008. The outcome of the procedures, the complication rates and its long-term effect were reviewed.
RESULTS: Overall, 116 PNE were performed and it was successful in 54%. Forty-five out of the 62 patients with a successful PNE underwent the stage I procedure. Of these, 93% had a successful stage I and were later implanted with the implantable pulse generator (IPG). The remaining 12 patients underwent the simultaneous implantation of the PPTL and IPG using the open procedure and it was successful in 10 of them.
CONCLUSION: The PNE is a good adjunct to the staged procedure to select the appropriate candidates for sacral nerve stimulation, especially with limited resources.

Entities:  

Year:  2011        PMID: 22154635      PMCID: PMC3235206          DOI: 10.5489/cuaj.11090

Source DB:  PubMed          Journal:  Can Urol Assoc J        ISSN: 1911-6470            Impact factor:   1.862


  24 in total

1.  Management of voiding dysfunction with an implantable neuroprosthesis.

Authors:  S W Siegel
Journal:  Urol Clin North Am       Date:  1992-02       Impact factor: 2.241

2.  Long term results of neuromodulation by sacral nerve stimulation for lower urinary tract symptoms: a retrospective single center study.

Authors:  A C van Voskuilen; D J A J Oerlemans; E H J Weil; R A de Bie; Ph E V A van Kerrebroeck
Journal:  Eur Urol       Date:  2006-01-04       Impact factor: 20.096

3.  Sacral root neuromodulation in idiopathic nonobstructive chronic urinary retention.

Authors:  H S Shaker; M Hassouna
Journal:  J Urol       Date:  1998-05       Impact factor: 7.450

Review 4.  Electrical stimulation in the clinical management of the neurogenic bladder.

Authors:  E A Tanagho; R A Schmidt
Journal:  J Urol       Date:  1988-12       Impact factor: 7.450

5.  Neuromodulation of sacral nerves for incontinence and voiding dysfunctions. Clinical results and complications.

Authors:  H E Dijkema; E H Weil; P T Mijs; R A Janknegt
Journal:  Eur Urol       Date:  1993       Impact factor: 20.096

6.  Predictors of success for first stage neuromodulation: motor versus sensory response.

Authors:  Brian L Cohen; Hari S G R Tunuguntla; Angelo Gousse
Journal:  J Urol       Date:  2006-06       Impact factor: 7.450

7.  Tolterodine and tamsulosin for treatment of men with lower urinary tract symptoms and overactive bladder: a randomized controlled trial.

Authors:  Steven A Kaplan; Claus G Roehrborn; Eric S Rovner; Martin Carlsson; Tamara Bavendam; Zhonghong Guan
Journal:  JAMA       Date:  2006-11-15       Impact factor: 56.272

8.  Long-term effectiveness of sacral nerve stimulation for refractory urge incontinence.

Authors:  R A Janknegt; M M Hassouna; S W Siegel; R A Schmidt; J B Gajewski; D A Rivas; M M Elhilali; D C Milam; P E van Kerrebroeck; H E Dijkema; A A Lycklama à Nÿeholt; M Fall; U Jonas; F Catanzaro; C J Fowler; K A Oleson
Journal:  Eur Urol       Date:  2001-01       Impact factor: 20.096

9.  Canadian experience in sacral neuromodulation.

Authors:  Mohamed Elkelini; Magdy M Hassouna
Journal:  Urol Clin North Am       Date:  2005-02       Impact factor: 2.241

10.  Sacral nerve stimulation for voiding dysfunction: One institution's 11-year experience.

Authors:  Suzette E Sutherland; Ann Lavers; Angeline Carlson; Cindy Holtz; Jyothi Kesha; Steven W Siegel
Journal:  Neurourol Urodyn       Date:  2007       Impact factor: 2.696

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  1 in total

1.  Helping patients with voiding dysfunction: What are our current options?

Authors:  Kurt A McCammon
Journal:  Can Urol Assoc J       Date:  2011-12       Impact factor: 1.862

  1 in total

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