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LONG-TERM RESULTS OF SACRAL NERVE STIMULATION (S3) FOR THE TREATMENT OF NEUROGENIC REFRACTORY URGE INCONTINENCE RELATED TO DETRUSOR HYPERREFLEXIA

2000; Lippincott Williams & Wilkins; Volume: 164; Issue: 5 Linguagem: Inglês

10.1016/s0022-5347(05)67010-3

1527-3792

Emmanuel Chartier‐Kastler, J.L.H. Ruud Bosch, M Perrigot, MICHAEL B. CHANCELLOR, François Richard, P. Denys,

Anorectal Disease Treatments and Outcomes

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Nov 2000LONG-TERM RESULTS OF SACRAL NERVE STIMULATION (S3) FOR THE TREATMENT OF NEUROGENIC REFRACTORY URGE INCONTINENCE RELATED TO DETRUSOR HYPERREFLEXIA EMMANUEL J. CHARTIER-KASTLER, J.L. H. RUUD BOSCH, MICHEL PERRIGOT, MICHAEL B. CHANCELLOR, FRANÇOIS RICHARD, and PIERRE DENYS EMMANUEL J. CHARTIER-KASTLEREMMANUEL J. CHARTIER-KASTLER , J.L. H. RUUD BOSCHJ.L. H. RUUD BOSCH , MICHEL PERRIGOTMICHEL PERRIGOT , MICHAEL B. CHANCELLORMICHAEL B. CHANCELLOR , FRANÇOIS RICHARDFRANÇOIS RICHARD , and PIERRE DENYSPIERRE DENYS View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67010-3AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We assess clinical and urodynamic results of sacral nerve stimulation for patients with neurogenic (spinal cord diseases) urge incontinence and detrusor hyperreflexia resistant to parasympatholytic drugs. Materials and Methods: Since 1992, 9 women with a mean age of 42.6 years (range 26 to 53) were treated for refractory neurogenic urge incontinence with sacral nerve stimulation. Neurological spinal diseases included viral and vascular myelitis in 1 patient each, multiple sclerosis in 5 and traumatic spinal cord injury in 2. Mean time since neurological diagnosis was 12 years. All patients had incontinence with chronic pad use related to detrusor hyperreflexia. Intermittent self-catheterization for external detrusor-sphincter dyssynergia was used by 5 patients. Social life was impaired and these patients were candidates for bladder augmentation. A sacral (S3) lead was surgically implanted and connected to a subcutaneous neurostimulator after a positive test stimulation trial. Results: Mean followup was 43.6 months (range 7 to 72). All patients had clinically significant improvement of incontinence, and 5 were completely dry. Average number of voids per day decreased from 16.1 to 8.2. Urodynamic parameters at 6 months after implant improved significantly from baseline, including maximum bladder capacity from 244 to 377 ml. and volume at first uninhibited contraction from 214 to 340 ml. Maximum detrusor pressure at first uninhibited contraction increased in 3, stabilized in 2 and decreased in 4 patients. Urodynamic results returned to baseline when stimulation was inactivated. All patients subjectively reported improved visual analog scale results by at least 75% at last followup. Conclusions: Sacral nerve stimulation can be used as a reversible treatment option for refractory urge incontinence related to detrusor hyperreflexia in select patients with spinal lesions. References 1 : Treatment of unstable bladder. Urology1991; 37: 28. Google Scholar 2 : Mechanism underlying the recovery of urinary bladder function following spinal cord injury. J Auton Nerv Syst1990; 30: S71. Google Scholar 3 : Bladder afferent pathway and spinal cord injury: possible mechanisms inducing hyperreflexia of the urinary bladder. Prog Neurobiol1999; 57: 583. Crossref, Medline, Google Scholar 4 : Intravesical capsaicin and resiniferatoxin therapy: spicing up the ways to treat the overactive bladder. J Urol1999; 162: 3. Link, Google Scholar 5 : The first 500 sacral anterior root stimulator implants: general description. Paraplegia1994; 32: 795. 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Google Scholar From the Departments of Urology and Neurologic Rehabilitation, Pitié-Salpétrière Hospital, University Pierre et Marie Curie (Paris VI), Paris, Department of Neurological Rehabilitation, Raymond Poincaré Hospital, Université Paris-ouest, Garches, France, Department of Urology, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands, and Department of Urologic Surgery, Neuro-Urology and Urinary Incontinence Programs, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania© 2000 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byStaskin D (2018) Stimulating Aspects of Sacral Nerve StimulationJournal of Urology, VOL. 175, NO. 6, (1991-1992), Online publication date: 1-Jun-2006.Groen J, Ruud Bosch J and van Mastrigt R (2018) Sacral Neuromodulation in Women With Idiopathic Detrusor Overactivity Incontinence: Decreased Overactivity but Unchanged Bladder Contraction Strength and Urethral Resistance During VoidingJournal of Urology, VOL. 175, NO. 3, (1005-1009), Online publication date: 1-Mar-2006.ROUPRET M, CHARTIER-KASTLER E, ALMERAS C, AYOUB N, HAERTIG A and RICHARD F (2018) SACRAL NEUROMODULATION FOR REFRACTORY DETRUSOR OVERACTIVITY IN WOMEN WITH AN ARTIFICIAL URINARY SPHINCTERJournal of Urology, VOL. 172, NO. 1, (236-239), Online publication date: 1-Jul-2004.DIOKNO A, LEU P and KONSTANDT D (2018) A Simplified Method of Implanting a Neuromodulator DeviceJournal of Urology, VOL. 169, NO. 4, (1466-1469), Online publication date: 1-Apr-2003.WISEMAN O, HOMBERGH U, KOLDEWIJN E, SPINELLI M, SIEGEL S and FOWLER C (2018) SACRAL NEUROMODULATION AND PREGNANCYJournal of Urology, VOL. 167, NO. 1, (165-168), Online publication date: 1-Jan-2002.CAPPELLANO F, BERTAPELLE P, SPINELLI M, CATANZARO F, CARONE R, ZANOLLO A, DE SETA F and GIARDIELLO G (2018) QUALITY OF LIFE ASSESSMENT IN PATIENTS WHO UNDERGO SACRAL NEUROMODULATION IMPLANTATION FOR URGE INCONTINENCE: AN ADDITIONAL TOOL FOR EVALUATING OUTCOMEJournal of Urology, VOL. 166, NO. 6, (2277-2280), Online publication date: 1-Dec-2001. Volume 164Issue 5November 2000Page: 1476-1480 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsreflex, abnormalbladder, neurogenicurinary incontinencesacrumMetrics Author Information EMMANUEL J. CHARTIER-KASTLER More articles by this author J.L. H. RUUD BOSCH More articles by this author MICHEL PERRIGOT More articles by this author MICHAEL B. CHANCELLOR Financial interest and/or other relationship with Afferon, Alza Pharmaceuticals, Medtronic, Pharmacia Upjohn and Situs, Inc. More articles by this author FRANÇOIS RICHARD Financial interest and/or other relationship with Lab Fabre, Fournier Debat, Ethicon and Boeringer Ingelheim. More articles by this author PIERRE DENYS More articles by this author Expand All Advertisement PDF downloadLoading ...