Sacral neuromodulation for chronic pain conditions

Feler, Claudio A.; Whitworth, Louis A.; Fernandez, J.M.

doi:10.1016/s0889-8537(03)00085-3

Cited by 70 publications

(71 citation statements)

References 35 publications

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“…Often, bilateral leads are placed percutaneously in a retrograde manner via the epidural space at a lumbar level. 2,37 Haque and Winfree 2 described a variety of techniques, including transforaminal, intraspinal, extraforaminal, and transspinal approaches. A percutaneous retrograde approach can be compromised by epidural fibrosis, stenosis, and spondylolisthesis.…”

Section: Surgical Techniquesmentioning

confidence: 99%

“…Techniques and generators with multiple electrodes derived from spinal cord stimulation using multiple quadripolar electrodes have also been used, placed via a cephalocaudal approach. 8 Feler et al 37 reported using a antegrade placement of four quadripolar electrodes with two following the course of S2 and the second medial pair overlying the S3 and S4 roots; they had treated 40 patients with interstitial cystitis and other pelvic pain and obtained an average reduction of visual analog pain scores of 55%.…”

Section: Figmentioning

confidence: 99%

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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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Section: Surgical Techniquesmentioning

confidence: 99%

Section: Figmentioning

confidence: 99%

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Mayer

Howard

2008

Neurotherapeutics

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“…[11][12][13][14][15] Few papers reported the effect of SNM therapy on female sexual function in mixed population groups with voiding dysfunction, fecal incontinence, 16 and chronic pelvic pain. [17][18] It is uncertain if the reported effect of SNM therapy in female sexual function is direct to stimulation or secondary to primary disease therapy and overall improved quality of life. Also, measurement of sexual function is notoriously difficult and relies on subjective patient-reported data on a potentially embarrassing topic.…”

Section: Introductionmentioning

confidence: 99%

Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

Banakhar

Gazwani²,

Kelini³

et al. 2014

CUAJ

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Cite as: Can Urol Assoc J 2014;8(11-12):e762-7. http://dx.doi.org/10.5489/cuaj.2300 Published online November 24, 2014. AbstractIntroduction: Sacral neuromodulation (SNM) has become an established therapy for voiding dysfunction. Additional benefits, such as improved bowel functions and bladder pain, have been reported. Improvement in female sexual function after SNM treatment has been suggested; however, reports examining the effects of SNM on female sexual functions are scarce. We evaluate the effects of SNM on female sexual function and its impact on quality of life and analyze any correlation. Methods: Data were collected from January 2010 to May 2012 for all female patients who underwent SNM InterStim (Medtronic, Minneapolis, MN) therapy at a single centre in Canada. They were treated for voiding dysfunction, including refractory overactive bladder, frequency-urgency syndrome and non-obstructive urinary retention. Patients were screened by percutaneous nerve evaluation (PNE) to assess their response to therapy using a 4-day voiding diary. Patients who experienced 50% or more improvement in their voiding parameters were permanently implanted. All patients completed the Female Sexual Function Index (FSFI), Short-Form Health Survey (SF-36), and incontinence questionnaires (Urinary Distress Inventory [UDI]-6) preoperatively and 4 months postoperatively. Results: A total of 33 female patients had SNM therapy; 10 were excluded from the study because they were not sexually active. The indications were: refractory overactive bladder in 19, frequencyurgency syndrome in 2, and non-obstructive urinary retention in another 2 patients. SNM therapy significantly improved the total FSFI score (p = 0.011); the components of desire and orgasm showed significant improvement (p = 0.014 and p = 0.035, respectively). Age, body mass index, diagnosis, and urinary symptoms did not show significant correlation with FSFI score improvement. Quality of life showed significant improvement after SNM treatment in 5 categories. There was no correlation between improvement in quality of life and FSFI. Conclusion: SNM may improve female sexual function and quality of life, yet there is no correlation between the improvement in FSFI and quality of life.

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“…In recent years, based on the studies conducted by Heine et al (4) and Schmidt (5), the achievement of sphincter activity by S3 nerve root stimulation guided several studies. The first sacral neuromodulation application was performed by Feler et al (6) in 1981, with indications of urinary incontinence, urinary frequency, and non-obstructive urinary retention. In addition, similar studies have been conducted for fecal incontinence (7,8).…”

Section: Historymentioning

confidence: 99%

“…This wide area explains the complexity of the diseases of the pelvic region and the difficulty of treatment processes. Although not falling within the purview of this paper, medical treatments, physiotherapy methods, sympathetic-and somatic block applications, and surgical interventions used in treatment strategies are directed towards these complex neuronal mechanisms (6).…”

Section: Mechanism Of Actionmentioning

confidence: 99%

A Different Option for Neuromodulation Procedures: Sacral Nerve Stimulation

Ozyalcin¹

2015

Turk J Phys Med Rehab

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The aim of this article is to determine the effectiveness and the safety of sacral nerve stimulation on the several indications. Sacral nerve stimulation as a neuromodulation technique, is an effective and increasingly used therapeutic option. As a minimally invasive technique, many advances in the techniques for sacral neuromodulation have been described. The well-known indication of sacral nerve stimulation is the urinary voiding dysfunction. Although the mechanism of neuromodulation is still unclear, multipl new indications have been identified, include faecal incontinence, constipation, pain sydromes, interstitial cystitis, mixt urinary and bowel disoders, spinal injury and neurodegenerative disease, and sexual dysfunction. Since there is lack of high quality evidence of the procedure at present, good quality prospective, cross-over and randomize controlled studies are required to determine the true benefits of sacral nerve stimulation.

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Sacral neuromodulation for chronic pain conditions

Cited by 70 publications

References 35 publications

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Sacral Nerve Stimulation: Neuromodulation for Voiding Dysfunction and Pain

Effect of sacral neuromodulation on female sexual function and quality of life: Are they correlated?

A Different Option for Neuromodulation Procedures: Sacral Nerve Stimulation

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