Neuroprostheses in the management of incontinence in myelomeningocele patients.
A 16-year-old boy and a 17-year-old girl underwent successful closure of the meningomyelocele defect in childhood but they continued to suffer incontinence of stool and urine. After a 5-day trial with percutaneous electrostimulation of the pudendal nerve both patients received permanent neuroprosthetic implants. They became completely continent of stool and exhibited greater than 90% improvement in urinary control. These patients demonstrate that there is a small subset of meningomyelocele patients who, despite absence of spontaneous reflex tonus in the urinary and bowel sphincters, nevertheless have preserved motor capabilities.
Schmidt
R A
RA
Department of Urology, University of California School of Medicine, San Francisco.
Kogan
B A
BA
Tanagho
E A
EA
D000293:Adolescent; D001003:Anal Canal / Q000294:innervation / Q000503:physiopathology; D004599:Electric Stimulation Therapy / Q000295:instrumentation; D004567:Electrodes, Implanted; D005242:Fecal Incontinence / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008591:Meningomyelocele / Q000150:complications*; D019736:Prostheses and Implants; D014521:Urethra / Q000294:innervation / Q000503:physiopathology; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology; D014549:Urinary Incontinence / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*