Sakralnervestimulering

Abstract

SummaryBackground. Sacral nerve stimulation involves electrical stimulation of a sacral nerve root by means of an electrode and a stimulator. In the course of just a few years, sacral nerve stimulation has become a treatment option for selected patients with urinary retention, urinary incontinence, anal incontinence and constipation. The method is also being tested in connection with several other indications.

Sacral neuromodulation: an effective treatment for lower urinary tract symptoms in multiple sclerosis

“…However, an accurate and comprehensive evaluation is mandatory to improve the chance of successful response to treatment. Age is not a limitation, but its role is still controversial, as patients older than 65 years seem less likely to be eligible for SNM [26,32]; motivation, ability to handle the remote control and realistic expectations are other important factors to consider [32,33]. Psychiatric disorders and psychological factors had been advocated as predictors of failure, but recently this relationship has not been confirmed [26,31].…”

“…Patients suffering from neurological diseases such as MS, should be carefully evaluated and, although there is a lack of randomized controlled trials, SNM is usually offered if the course of the underlying neurological disorder can be considered stable or slowly progressive and patients are not likely to require repeated magnetic resonance scans [32,33]. In fact, it has been reported that loss of efficacy over time is a result of a new relapse [20,22,23].…”

Is Permanent Sacral nerve Stimulation Implantation Under Local Anaesthesia Feasible and Effective?

“…The exact mechanism by which SNS works is not completely understood (6). The improved clinical outcome has been suggested to arise, as a result of the modulative effect that the electrical current delivered via the electrode exerts on the sacral nerve root and its corresponding neuromuscular components (1,7,8).…”

“…Sacral nerve stimulation (SNS) is a minimally invasive surgical technique that plays an important role in the treatment of disorders of the bladder and bowel (1). Over time the scope of conditions that SNS benefits has broadened; it was originally indicated in patients with urinary incontinence and non-obstructive urinary retention in 1981 (2,3).…”

“…To help identify patients who are likely to respond to and benefit from this intervention, candidates undergo a trial course of stimulation for two weeks (1). During this period of assessment, a temporary percutaneously placed electrode is inserted into either the 3rd or 4th sacral foramen and connected to an external pulse generator (2,6).…”