Use of chronic sacral nerve stimulation in neurological voiding disorders.
OBJECTIVE
Neurogenic low urinary tract dysfunctions unresponsive to medical and conservative therapy are difficult to manage. Nowadays they can be treated with Sacral Nerve Stimulation (SNS), even if clinical experiences reported in literature are still limited.


METHODS
We performed SNS in 6 patients with neurogenic bladder: 3 patients had incontinence-urgency (1 myelitis, 1 multiple sclerosis, 1 autonomic polineuropathy) and 3 patients had urinary retention (1 incomplete spinal cord lesion, 1 operation for discal hernia T5-T6, 1 hysterectomy).


RESULTS
Among cases with incontinence-urgency we achieved complete control of the bladder in 2 patients while in 1 patient the number of urinary losses was reduced of the 80%. In 2 patients with urinary retention we obtained complete recovery of the bladder function, while in 1 patient the number of cateterisms/die reduced of 50%, the urinary volume for micturion increased and residual urinary volume decreased. Results were unchanged during the follow-up (maximum 26 months), except for 1 patient in which a partial loss of effectiveness occurred.


CONCLUSIONS
Chronic electric stimulation of S3 sacral roots via an implanted neuroprotesis is therefore an effectiveness, save and promising therapeutic option in treatment of neurogenic bladder dysfunctions.
Lavano
A
A
Division of Neurosurgery, Department of Experimental and Clinical Medicine, G. Salvatore, Faculty of Medicine, Magna Graecia, University of Catanzaro, Italy. lavano@unicz.it
Volpentesta
G
G
Aloisi
M
M
Veltri
C
C
Piragine
G
G
Signorelli
C D
CD
D004599:Electric Stimulation Therapy / Q000295:instrumentation / Q000379:methods*; D004567:Electrodes, Implanted / Q000592:standards / Q000639:trends; D006801:Humans; D007001:Hypogastric Plexus / Q000033:anatomy & histology / Q000502:physiology; D008160:Lumbosacral Plexus / Q000033:anatomy & histology / Q000502:physiology* / Q000601:surgery; D008959:Models, Neurological; D009119:Muscle Contraction / Q000502:physiology; D036421:Nerve Fibers, Unmyelinated / Q000502:physiology; D010275:Parasympathetic Nervous System / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D017060:Patient Satisfaction; D017773:Pelvic Floor / Q000294:innervation / Q000503:physiopathology; D011788:Quality of Life; D012018:Reflex / Q000502:physiology; D013126:Spinal Nerve Roots / Q000033:anatomy & histology / Q000502:physiology / Q000601:surgery; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D014554:Urination / Q000502:physiology