Neuromodulation : journal of the International Neuromodulation Society
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Lead placement within the sacral foramen in sacral neuromodulation patients is guided by visual assessment of the contraction of the pelvic floor musculature (PFM) and/or verbal assessment of the sensation and location of sensation upon stimulation. Generally, lead placement is proceeded by needle probing. This study evaluates which location inside a single sacral foramen would be most ideal for the release of the permanent electrode lead, by measuring electromyographic (EMG) motor responses of the PFM upon stimulation of a peripheral nerve evaluation (PNE) needle. ⋯ Our data suggest stronger PFM contractions are elicit in cranial- and medial-placed PNE needles upon stimulation with clinically relevant current amplitudes (≤ 2 mA). Placement of the lead should aim for this spot in the foramen.
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Sacral nerve stimulation (SNS) is an effective treatment for refractory overactive bladder (OAB). However, advanced age is often cited as a reason to avoid SNS in the elderly. This study evaluates the safety and efficacy of SNS for refractory OAB among our octogenarian population. ⋯ The safety and efficacy of SNS was similar between cohorts. This result suggests that SNS is a safe and effective therapy that should be considered among the treatment options for refractory OAB in octogenarian patients. Further studies are needed to determine predictive factors of Stage I success in elderly patients.
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The objective was to assess the efficacy and the safety of sacral nerve modulation (SNM) in men with fecal incontinence (FI) compared with those of SNM in women. ⋯ Both short- and long-term success rates of SNM for FI were lower in men than in women. The revision and definitive explantation for long-term infection rates were significantly higher in men.
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Incomplete spinal cord injury (SCI) accounts for two-thirds of all SCIs in clinical practice. Preclinical research on the effect of sacral neuromodulation (SNM) on bladder function, however, has been focused only on animal models of complete SCI. We aimed to evaluate the effect of early SNM on bladder responses in a rat model of incomplete SCI. ⋯ Our results provide experimental evidence that early SNM treatment may prevent or diminish bladder dysfunctions (e.g., detrusor overactivity, abnormal micturition reflex) in a clinical condition of incomplete SCI.