Buttock Placement of the Implantable Pulse Generator: A New Implantation Technique for Sacral Neuromodulation &amp;ndash; A Multicenter Study

Scheepens, W.A.; Weil, E.H.J.; Koeveringe, Gommert van; Rohrmann, Dorothea; Hedlund, Hans; Schurch, Brigitte; Ostardo, Edoardo; Pastorello, Mauro; Ratto, Carlo; Nordling, Jørgen; Kerrebroeck, Ph.E.V. Van

doi:10.1159/000049812

Cited by 89 publications

(36 citation statements)

References 19 publications

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“…Significantly many patients described problems with box-site discomfort; whereas the initial IPGs were placed in the abdomen, this technique was later superseded by placing the IPG in the buttock [16]. In the present series both sites caused problems, with four of nine patients describing the buttock placement as particularly uncomfortable when supine.…”

Section: Discussionmentioning

confidence: 59%

Long‐term results of sacral neuromodulation for women with urinary retention

et al. 2004

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RESULTSThere were 20 patients (77%) still voiding spontaneously at the time of review (with two having deactivated their stimulator because of pregnancy). Fourteen patients (54%) required revision surgery, and the most common complications included loss of efficacy, implant-related discomfort and leg pain. The mean postvoid residual volume was 75 mL and mean maximum flow rate 20.8 mL/s. CONCLUSIONIn young women with retention, for whom there is still no alternative to lifelong selfcatheterization, sacral neuromodulation is effective for up to 5 years after implantation. However, there was a significant complication rate, in line with other reports, which may be improved by new technical developments. KEYWORDSsacral neuromodulation, Fowler's syndrome, urinary retention, women OBJECTIVETo review the long-term results of sacral nerve stimulation in the treatment of women with Fowler's syndrome, over a 6-year period at one tertiary referral centre. 1996 and 2002, 26 women with urinary retention were treated by implanting a sacral nerve stimulator. Their case records were reviewed for follow-up, complications and revision procedures, and the most recent uroflowmetry results. PATIENTS AND METHODS Between

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Section: Discussionmentioning

confidence: 59%

Long‐term results of sacral neuromodulation for women with urinary retention

et al. 2004

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“…One patient (4.2%) underwent a two-stage 'buttock' procedure in which, during the second stage, the position of the implantable pulse generator was changed with respect to the original single surgical procedure from the subcutaneous pocket at the lower part of the anterior abdominal wall to the buttock. 8 The remaining 19 individuals (79.1%) were implanted using the percutaneous second stage procedure. All patients underwent placement of unilateral implantation in the sacral S3 root.…”

Section: Methodsmentioning

confidence: 99%

Clinical outcome of sacral neuromodulation in incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms

Lombardi

Popolo

2009

Spinal Cord

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Objective: To determine the efficacy and safety of sacral neuromodulation (SNM) in incomplete spinal cord injured (SCI) subjects affected by neurogenic lower urinary tract symptoms (NLUTS). Methods: Twenty-four SCI patients were enrolled. The individuals were divided into two groups: 13 individuals in the urinary retention category and 11 suffering from overactive bladder syndrome. All subjects underwent definitive SNM implantation (Medtronic, Inc.). Voiding symptoms were assessed using patient bladder diaries, which recorded both pre-SNM and before each follow-up (1, 3 and 6 months, and then every 6 months). Outcome measures were per 24 h: number of voids and voided volume per void for both groups; number of urinary leakages, pad use and nocturia for patients with overactive bladder syndrome; and volume per catheterization and number of catheterizations for urinary retention subjects only. Final checkups were completed by June 2008. Results: Median follow-up was 61 months. Up to the final visit, all subjects maintained a clinical improvement of more than 50% compared with baseline. Twenty-two side effects were recorded. Four subjects with urinary retention needed a new implant in the controlateral S3 sacral root because of loss of efficacy. One patient with urinary retention developed a wound infection at the implanted pulse generator site. Conclusions: Our study contains the largest series of implanted SCI patients ever published. SNM is a therapy to consider in the treatment of NLUTS for partial SCI patients, even if the loss of clinical benefits for patients with retentive NLUTS must be taken into account. All adverse events were treated effectively.

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“…Currently, the generator in most cases is implanted in the subcutaneous tissue in the buttock region, which has been found to be acceptable and simplify the operative procedure. 28 Subsequent modifications to the technique included use of needles, wires, and dilators to place the electrode within the foramen next to the nerve root without the need to incise overlying muscle and fascia. Initially this was performed using an anchor system to the lumbodorsal fascia.…”

Section: Surgical Techniquesmentioning

confidence: 99%

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Mayer

Howard

2008

Neurotherapeutics

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Summary:Voiding dysfunction, which includes incontinence, retention, and chronic pelvic pain, is a relatively frequent problem that can be difficult to manage. Neuromodulation via stimulation of the sacral nerves has been shown to improve thesesymptoms, although the exact mechanisms remain elusive. Techniques for nerve stimulation may vary, depending on the disease, location of pain, and the patient's anatomy. In addition to placement of electrodes on the sacral nerve roots, modulation has also been reported by peripheral branches of the sacral nerves including the pudendal and posterior tibial nerves. Newer surgical techniques have significantly decreased the morbidity of the procedures and increased the probability of a successful outcome.

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Buttock Placement of the Implantable Pulse Generator: A New Implantation Technique for Sacral Neuromodulation – A Multicenter Study

Cited by 89 publications

References 19 publications

Long‐term results of sacral neuromodulation for women with urinary retention

Long‐term results of sacral neuromodulation for women with urinary retention

Clinical outcome of sacral neuromodulation in incomplete spinal cord injured patients suffering from neurogenic lower urinary tract symptoms

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

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