Sacral Root Neuromodulation in the Treatment of Refractory Urinary Urge Incontinence: A Prospective Randomized Clinical Trial

Weil, E.H.J.; Ruiz-Cerdá, J.L.; Eerdmans, Pedro; Janknegt, R. A.; Bemelmans, Bart L.H.; Kerrebroeck, Ph.E.V. Van

doi:10.1159/000020134

Cited by 166 publications

(109 citation statements)

References 18 publications

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“…While in the urgency incontinence group their efficacy was unchanged 46% at 6 months and 3 years but only 59% as opposed to 87% showed a greater than 50% improvement in the number of leakage episodes . Further, a multicenter 5-year prospective trial showed reduction of number of leakage episodes and pads used in patients with urgency incontinence and decrease in frequency and urgency and [Hassouna et al 2000;Hijaz et al 2006;Sutherland et al 2007;van Voskuilen et al 2006Weil et al 2000 increase in mean voided volume per micturition episode in OAB dry patients . By contrast, the 2-year follow up of a group of OAB patients who had participated in a multicenter randomized trial, had sustained efficacy concerning the improvement in the number of total voids/day, the mean voided volume per micturition and the degree of urgency [Hassouna et al 2000].…”

Section: Efficacymentioning

confidence: 99%

“…The objective response will be evaluated on voiding diaries the patient will fill them before insertion which will be compared with the other one filled during the test period. The overall response rate for PNE is around 55% [Schmidt et al 1999;Weil et al 2000]. Lead migration is considered the main factor leading to false-negative results [Everaert et al 2004;Janknegt et al 1997].…”

Section: One-stage Implantationmentioning

confidence: 99%

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Sacral neuromodulation and refractory overactive bladder: an emerging tool for an old problem

Banakhar

Al-Shaiji

Hassouna

2012

Therapeutic Advances in Urology

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Overactive bladder (OAB) syndrome negatively affects the daily life of many people. Conservative treatments, such as antimuscarinics, do not always lead to sufficient improvement of the complaints and are often associated with considerable side effects resulting in treatment failure. In the case of failure or intolerable side effects, sacral neuromodulation (SNM) and botulinum toxin intravesical injections are minimally invasive and reversible alternatives. Currently, both SNM and botulinum toxin injection have FDA approval for use in OAB patients. This mini-review attempts to provide an update on SNM as a secondline management of adults with refractory OAB, based on the available clinical evidence concerning the efficacy and safety.

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Section: Efficacymentioning

confidence: 99%

Section: One-stage Implantationmentioning

confidence: 99%

Sacral neuromodulation and refractory overactive bladder: an emerging tool for an old problem

Banakhar

Al-Shaiji

Hassouna

2012

Therapeutic Advances in Urology

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“…Although temporary and chronic SNS can result in significant permanent clinical improvement, some patients improve only partially or temporarily [34, 35]. For these patients, several methods have been developed to improve the results [30–32].…”

Section: Unilateral or Bilateral Stimulationmentioning

confidence: 99%

Advances in the role of sacral nerve neuromodulation in lower urinary tract symptoms

Kerrebroeck

2010

Int Urogynecol J

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Sacral neuromodulation has been developed to treat chronic lower urinary tract symptoms, resistant to classical conservative therapy. The suspected mechanisms of action include afferent stimulation of the central nervous system and modulation of activity at the level of the brain. Typical neuromodulation is indicated both in overactivity and in underactivity of the lower urinary tract. In the majority of patients, a unilateral electrode in a sacral foramen and connected to a pulse generator is sufficient to achieve significant clinical results also on long term. In recent years, other urological indications have been explored.

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“…41,42 For these patients several methods have been developed to improve the results. 37 -39 The most widely accepted method to test a patient for SNS therapy is unilateral stimulation.…”

Section: Unilateral or Bilateral Stimulationmentioning

confidence: 99%

Sacral nerve stimulation for neuromodulation of the lower urinary tract

Oerlemans

Kerrebroeck

2007

Neurourology and Urodynamics

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Patients with symptoms of overactive bladder syndrome or non-obstructive urinary retention, refractory to conservative therapy, can nowadays be treated minimally invasively with sacral nerve stimulation (SNS). The use of electric currents to treat urological pathology has a long history but SNS therapy only received FDA approval in 1997. The mechanisms of action are still not known so there are different theories explaining the modulation effect. Recent studies have shown a central modulation effect. Predictive factors which can help to identify the perfect candidates are not known. Over the years the technique of SNS has become less invasive and because of two stage implantation test results have proven to be more reliable. The clinical results for this therapy have proven to be safe and effective and with the technical improvements over the years the re-operation and complication rates have decreased significantly. The clinical results have led to expanding indications because of positive effects in other symptoms. In the field of urology this has resulted in the use of SNS therapy for interstitial cystitis, neurogenic lower urinary dysfunction, and pediatric voiding dysfunction. In the field of gastro-intestinal pathology, SNS therapy is used to treat faecal incontinence and constipation.

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Sacral Root Neuromodulation in the Treatment of Refractory Urinary Urge Incontinence: A Prospective Randomized Clinical Trial

Cited by 166 publications

References 18 publications

Sacral neuromodulation and refractory overactive bladder: an emerging tool for an old problem

Sacral neuromodulation and refractory overactive bladder: an emerging tool for an old problem

Advances in the role of sacral nerve neuromodulation in lower urinary tract symptoms

Sacral nerve stimulation for neuromodulation of the lower urinary tract

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