Howard B Goldman1, Jessica C Lloyd1, Karen L Noblett2, Marcus P Carey3, Juan Carlos Castaño Botero4, Jerzy B Gajewski5, Paul A Lehur6, Magdy M Hassouna7, Klaus E Matzel8, Ian M Paquette9, Stefan de Wachter10, Michael J Ehlert11, Emmanuel Chartier-Kastler12, Steven W Siegel11. 1. Glickman Urology and Kidney Institute, Cleveland Clinic, Cleveland, Ohio. 2. Axonics Modulation Technologies and Department of Obstetrics and Gynecology, University of California-Irvine, Irvine, California. 3. Division of Urogynaecology, Frances Perry House, Parkville, Victoria, Australia. 4. Department of Urology, CES University Clinic, Medellín, Colombia. 5. Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada. 6. Clinique de Chirurgie Digestive et Endocrinienne, Universite de Nantes, Nantes, France. 7. Division of Urology, University of Toronto, Toronto, Ontario, Canada. 8. Division of Coloproctology, University of Erlangen, Erlangen, Germany. 9. Department of Surgery, Division of Colon and Rectal Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio. 10. Department of Urology, University Hospital Antwerpen, University of Antwerpen, Belgium. 11. Minnesota Urology, Woodbury, Minnesota. 12. Department of Urology, Academic Hospital Pitié-Salpétrière, Medical School Sorbonne Université, Paris, France ECK.
Abstract
AIMS: Sacral neuromodulation (SNM) is an accepted therapy for a variety of conditions. However, despite over 20 years of experience, it remains a specialized procedure with a number of subtleties. Here we present the recommendations issued from the International Continence Society (ICS) SNM Consensus Panel. METHODS: Under the auspices of the ICS, eight urologists, three colorectal surgeons and two urogynecologists, covering a wide breadth of geographic and specialty interest representation, met in January 2017 to discuss best practices for neuromodulation. Suggestions for statements were submitted in advance and specific topics were assigned to committee members, who prepared and presented supporting data to the group, at which time each topic was discussed in depth. Best practice statements were formulated based on available data. This document was then circulated to multiple external reviewers after which final edits were made and approved by the group. RESULTS: The present recommendations, based on the most relevant data available in the literature, as well as expert opinion, address a variety of specific and at times problematic issues associated with SNM. These include the use of SNM for a variety of underlying conditions, need for pre-procedural testing, use of staged versus single-stage procedures, screening for success during the trial phase, ideal anesthesia, device implantation, post-procedural management, trouble-shooting loss of device function, and future directions for research. CONCLUSIONS: These guidelines undoubtedly constitute a reference document, which will help urologists, gynecologists, and colorectal surgeons optimize their use of SNM for refractory urinary urgency and frequency, UUI, NOR, and FI.
AIMS: Sacral neuromodulation (SNM) is an accepted therapy for a variety of conditions. However, despite over 20 years of experience, it remains a specialized procedure with a number of subtleties. Here we present the recommendations issued from the International Continence Society (ICS) SNM Consensus Panel. METHODS: Under the auspices of the ICS, eight urologists, three colorectal surgeons and two urogynecologists, covering a wide breadth of geographic and specialty interest representation, met in January 2017 to discuss best practices for neuromodulation. Suggestions for statements were submitted in advance and specific topics were assigned to committee members, who prepared and presented supporting data to the group, at which time each topic was discussed in depth. Best practice statements were formulated based on available data. This document was then circulated to multiple external reviewers after which final edits were made and approved by the group. RESULTS: The present recommendations, based on the most relevant data available in the literature, as well as expert opinion, address a variety of specific and at times problematic issues associated with SNM. These include the use of SNM for a variety of underlying conditions, need for pre-procedural testing, use of staged versus single-stage procedures, screening for success during the trial phase, ideal anesthesia, device implantation, post-procedural management, trouble-shooting loss of device function, and future directions for research. CONCLUSIONS: These guidelines undoubtedly constitute a reference document, which will help urologists, gynecologists, and colorectal surgeons optimize their use of SNM for refractory urinary urgency and frequency, UUI, NOR, and FI.
Authors: A Zegrea; J Kirss; T Pinta; T Rautio; P Varpe; M Kairaluoma; M Aho; C Böckelman; M Lavonius Journal: Tech Coloproctol Date: 2020-01-21 Impact factor: 3.781
Authors: Mana H Vriesman; Ilan J N Koppen; Michael Camilleri; Carlo Di Lorenzo; Marc A Benninga Journal: Nat Rev Gastroenterol Hepatol Date: 2019-11-05 Impact factor: 46.802
Authors: Kevin Benson; Rebecca McCrery; Chris Taylor; Osvaldo Padron; Bertil Blok; Stefan de Wachter; Andrea Pezzella; Jennifer Gruenenfelder; Mahreen Pakzad; Marie-Aimee Perrouin-Verbe; Philip Van Kerrebroeck; Jeffrey Mangel; Kenneth Peters; Michael Kennelly; Andrew Shapiro; Una Lee; Craig Comiter; Margaret Mueller; Howard Goldman; Felicia Lane Journal: Neurourol Urodyn Date: 2020-04-27 Impact factor: 2.696