Bilateral S3 nerve stimulation, a minimally invasive alternative treatment for postoperative stress incontinence after implantation of an anterior root stimulator with posterior rhizotomy: a preliminary observation.
METHODS
A preliminary report.


OBJECTIVE
Urinary stress incontinence following implantation of an anterior root stimulator and a posterior rhizotomy is a rare complication which is difficult to treat. It is seen in patients with an open bladder neck (T9-L2 lesion). An artificial urinary sphincter is a possible treatment for this condition but has a higher failure rate in patients with neurogenic bladder disease and could complicate micturition.


METHODS
Ghent, Belgium.


METHODS
A male paraplegic patient (T9, complete lesion) aged 36 was suffering from severe urinary incontinence due to detrusor hyperreflexia. Preoperatively the bladder neck was closed on cystography. Following implantation (6/95) of an intradural anterior root stimulator with posterior rhizotomy, severe urinary stress incontinence presented. Bilateral S3 foramen leads were implanted and connected to a pulse generator.


RESULTS
The patient has been continent with continuous stimulation of both S3 roots for 4 years, and no fatigue of the levator muscles has been seen. Preoperative urodynamics are compared to results 3 years postoperatively.


CONCLUSIONS
Bilateral S3 stimulation is a feasible and minimally invasive treatment of urinary stress incontinence following implantation of an anterior root stimulator.
Everaert
K
K
Department of Urology, Ghent University Hospital, Ghent, Belgium.
Derie
A
A
Van Laere
M
M
Vandekerckhove
T
T
D000328:Adult; D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted / Q000009:adverse effects; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000628:therapy*; D019051:Rhizotomy / Q000009:adverse effects*; D013119:Spinal Cord Injuries / Q000150:complications*; D013126:Spinal Nerve Roots / Q000503:physiopathology* / Q000601:surgery; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000209:etiology / Q000628:therapy*; D014554:Urination