Neuromodulation : journal of the International Neuromodulation Society
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To assess the long-term functional outcomes of sacral neuromodulation (SNM) in the treatment of refractory idiopathic overactive bladder (IOAB) and to determine predictive factors for success. ⋯ With a median follow-up time of 9.7 years, this retrospective SNM study reports a 63% efficacy rate (≥ 50% improvement) for the treatment of refractory IOAB. Moreover, it is a well-tolerated and minimally invasive therapy.
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Comparative Study
Comparison of Active Stimulating Electrodes of Sacral Neuromodulation.
The goal of this study was to compare the motor response to sacral neuromodulation (SNM) with different pairs of stimulating electrodes in anesthetized and awake sheep. ⋯ Objective motor responses to SNM as a functional indicator for optimal lead placement may be used to demonstrate that the contact which is most proximal to the foramen (electrode 3) is an optimal electrode to trigger an "on-target" response to lower intensity stimulation. Data from this preclinical work suggest that there are several principles that may be referenced to simplify and expedite the programming process in clinical practice.
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Sacral neuromodulation (SNM) devices (Medtronic, Minneapolis, MN, USA) are not approved to undergo magnetic resonance imaging (MRI) of sites other than the head. When MRIs are required, devices are often removed prior to imaging. We reviewed the prevalence of device removal for MRI at a large academic institution and the subsequent clinical course of these patients. ⋯ In patients receiving SNM therapy, device removal for MRI is most commonly due to orthopedic and neurologic pathologies. About half of the MRIs performed impacted non-GU clinical management. It is of paramount importance to confirm the necessity of MRI before removing a functional SNM device. Since SNM replacement was rare in this cohort, research is needed on the safety of various MRI types with SNM devices in vivo.
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Stress is considered an independent factor causing and aggravating gastrointestinal symptoms, including visceral pain. The aim of this study was to investigate effects and mechanisms of electroacupuncture (EA) on stress-induced gastric hypersensitivity in rats treated with neonatal iodoacetamide mimicking human functional dyspepsia (FD). ⋯ Rats treated with neonatal iodoacetamide mimicking FD are more vulnerable to stress. Stress-induced gastric hypersensitivity can be prevented or suppressed by EA at ST36 via the restoration of sympathovagal balance.
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Comparative Study
Comparison of Bladder Inhibitory Effects of Patterned Spinal Nerve Stimulation With Conventional Neuromodulation in the Rat.
The present study compared the effectiveness of patterned frequency of spinal nerve stimulation (SNS) with continuous, fixed-frequency nerve stimulation in an animal model of the bladder reflex contraction (BRC). ⋯ Burst stimulations may inhibit bladder contractions; however, they are not more effective than continuous neuromodulation. Without further knowledge regarding mechanisms and potential benefit of burst stimulation on bladder control in patients with neuropathological conditions, applications should utilize continuous fixed 10 Hz stimulation for maximal clinical outcomes.