A New Minimally Invasive Procedure for Pudendal Nerve Stimulation to Treat Neurogenic Bladder: Description of the Method and Preliminary Data

Spinelli, M.; Malaguti, S.; Giardiello, G.; Lazzeri, Massimo; Tarantola, Jessica; Hombergh, Ubi van den

doi:10.1016/s0022-5347(05)00636-1

Cited by 22 publications

(44 citation statements)

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“…We started by using the established device for SNS already used for PNS by Spinelli et al [3]. The device was given an CE mark for PNS in 2008.…”

Section: Methodsmentioning

confidence: 99%

“…However, we found the placement of the tined lead, which is usually inserted under fluoroscopy, more demanding given the absence of useful anatomic landmarks. We therefore modified the technique described by Spinelli et al for the posterior approach [3]. With the patient in the prone position and under general anesthesia, the ischial spine on each side was marked by drawing two lines, one between the two greater trochanters and another extending cephalad from the tip of the ischial tuberosity.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The lower success rates in some urological disorders have led to the search for alternative methods [3]. Spinelli et al tested the possibility of pudendal nerve stimulation (PNS) in patients for whom SNS did not yield satisfactory results [3]. In their study, after a screening phase, a definitive impulse generator for PNS was successfully implanted in 12 out of 15 patients with neurogenic bladder dysfunction, resulting in total success or a significant reduction in incontinence.…”

Section: Introductionmentioning

confidence: 99%

“…We therefore began testing the method described by Spinelli et al [3]. We made a slight modification in the device, which resulted in a quick and easy-to-use method for PNS implantation.…”

Section: Introductionmentioning

confidence: 99%

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First experiences with pudendal nerve stimulation in fecal incontinence: a technical report

et al. 2010

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Sacral nerve stimulation (SNS) is an established treatment for refractory lower urinary tract and bowel dysfunction. In some urological patients, SNS does not have satisfactory results. Pudendal nerve stimulation (PNS) has recently been proposed for these patients and successfully tested. Given the sometimes unsatisfactory results after SNS in fecal incontinence (FI), we tested PNS on patients suffering from FI. We used the device and implantation technique described by Spinelli et al. By making a slight change in the device, we developed a quick and easy-to-use method for successful PNS implantation, based on electrophysiological response. We present the results of a feasibility study, in which we tested the effectiveness of PNS with our modified implantation technique on 2 patients, with very satisfactory early results in a 4-month follow-up.

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“…We started by using the established device for SNS already used for PNS by Spinelli et al [3]. The device was given an CE mark for PNS in 2008.…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…We therefore began testing the method described by Spinelli et al [3]. We made a slight modification in the device, which resulted in a quick and easy-to-use method for PNS implantation.…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

First experiences with pudendal nerve stimulation in fecal incontinence: a technical report

et al. 2010

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Chronic pudendal neuromodulation: Expanding available treatment options for refractory urologic symptoms

Peters

Killinger

Boguslawski

et al. 2010

Neurourology and Urodynamics

144

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New laparoscopic approach to the pudendal nerve for neuromodulation based on an anatomic study

Konschake

Brenner

Moriggl

et al. 2016

Neurourology and Urodynamics

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AIMS:The aim was to develop a new laparoscopic technique for placement of a pudendal lead. METHODS: Development of a direct, feasible and reliable minimal-invasive laparoscopic approach to the pudendal nerve (PN). Thirty-one embalmed human specimens were dissected for the relevant anatomic structures of the pelvis.Stepby-step documentation and analysis of the laparoscopic approach in order to locate the PN directly in its course around the medial part of the sacrospinous ligament and test this approach for feasibility. Landmarks for intraoperative navigation towards the PN as well as the possible position of an lead were selected and demonstrated. RESULTS: The visible medial umbilical fold, the intrapelvine part of the internal pudendal artery, the coccygeus muscle and the sacrospinous ligament are the main landmarks. The PN traverses the medial part of the sacrospinous ligament dorsally, medially to the internal pudendal artery. The medial part of the sacrospinous ligament has to be exposed in order to display the nerve. An lead can be placed ventrally on the nerve or around it, depending on the lead type or shape. CONCLUSIONS: A precise and reliable identification of the PN by means of laparoscopy is feasible with an easy four-step approach: (1) identification of the medial umbilical fold; (2) identification of the internal iliac artery; (3) identification of the internal pudendal artery and incision of the coccygeus muscle ('white line', arcuated line); and (4) exposition of the medial part of the sacrospinous ligament to display the PN. K E Y W O R D Sinternal pudendal artery, laparoscopic approach, medial umbilical fold, neuromodulation, pudendal nerve, sacrospinous ligament

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A New Minimally Invasive Procedure for Pudendal Nerve Stimulation to Treat Neurogenic Bladder: Description of the Method and Preliminary Data

Cited by 22 publications

References 0 publications

First experiences with pudendal nerve stimulation in fecal incontinence: a technical report

First experiences with pudendal nerve stimulation in fecal incontinence: a technical report

Chronic pudendal neuromodulation: Expanding available treatment options for refractory urologic symptoms

New laparoscopic approach to the pudendal nerve for neuromodulation based on an anatomic study

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