A new minimally invasive procedure for pudendal nerve stimulation to treat neurogenic bladder: Description of the method and preliminary data

Abstract

Chronic pundedal nerve stimulation is feasible. Neurophysiological guidance is mandatory to place the lead near the pudendal nerve either using perineal or posterior approach. Further studies must be carried out to identify the best stimulation parameters and to verify the long term results.

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

“…Spinelli and Peters and colleagues have used the tined lead used for InterStim therapy to chronically stimulate the pudendal nerve and have also reported promising results, with Peters reporting a possible superior effect of pudendal stimulation in a series of patients simultaneously implanted with both a sacral lead and pudendal leads. 62,63 Both series were small, however, and further study is needed.…”

Detrüsör Aşırı Aktivitesi Olan Omurilik Hasarlı Olgularda Sakral Dermatomal Transkutanöz Nörostimülasyon

“…Nöromodülasyon nörojenik ve nörojenik olmayan alt üriner sistem disfonksiyonu tedavisinde intravezikal elektriksel stimülasyon, direk mesane stimülasyonu, pelvik sinir stimülasyonu, pudendal sinir stimülasyonu, sakral spinal stimülasyon, dorsal rizotomi ile birlikte sakral anterior kök stimülasyonu, uyluk kaslarının elektriksel stimülasyonu, posterior tibial sinir stimülasyonu ve TENS (suprapubik veya S2-S3 dermatomlarına) gibi birçok değişik teknik ve cihazlarla uygulanmaktadır (4,14,(17)(18)(19)(20)(21)(22). S3 segmental sinir köklerinin cerrahi yöntemlerle implante edilen elektrotlarla direkt elektriksel stimülasyonu sonucu nörojenik detrüsör aşırı aktivitesinde başarılı sonuçlar alınması, daha kolay uygulanabilen, invaziv olmayan, belirgin yan etkisi bulunmayan, tedavi maliyeti daha düşük bir yöntem olan S3 dermatomuna yüzeyel elektrotlar ile TENS uygulamasını gündeme getirmiştir (4-7).…”

An update on sacral neuromodulation: where do we stand with this in the management of lower urinary tract dysfunction in 2010?

“…Male patients and patients with neurogenic bladder disease seem to respond poorly to SNM [86,87,93]. Technical advances such as the use of the tined lead, the two-stage implant, the smaller InterStim II IPG, buttock placement of the IPG and the less invasive partially percutaneous technique, seem to have decreased the necessity for revision [35,94].…”

“…Because of the poor results of SNM in patients with neurogenic bladder disease [86], Spinelli et al [87] have explored pudendal nerve stimulation with the tined lead and the InterStim device. Long-term results of this approach are awaited.…”