title: Extradural implantation of sacral anterior root stimulator in spinal cord injury patients.
abstract: To evaluate the efficacy and complications of extradural sacral anterior root stimulation (SARS) implantation in patients with neurogenic detrusor overactivity (NDO) resulting from spinal cord injury (SCI).
  
  
  
  A retrospective study was conducted between 2009 and 2013, on consecutive patients with NDO associated with SCI that underwent SARS implantation. We evaluated those factors related to clinical symptoms such as urinary infection rate, erections, and episodes of autonomic dysreflexia. Data from cystometric bladder capacity (CBC) and post-void residual (PVR) volume were also analyzed.
  
  
  
  Of the 104 patients included in the study, 95 (91%) patients were men with a mean (standard deviation) (SD) age of 38 (10) years. Mean (SD) time between the onset of SCI and the SARS was 78.2 (59.0) months. At baseline, 95 (91%) patients had urinary infections as compared with 16 (15%) after treatment, P < 0.001. The percentage of patients that had urinary incontinence was significantly higher at baseline than that observed after SARS, 100% versus 14%, respectively, P < 0.001. Similar results were obtained regarding dysreflexia, P < 0.001. After SARS, the mean (SD) bladder capacity was 362 (108) ml and 98 (94%) patients had a bladder capacity greater than 400 ml. As regard to the adverse effects, six patients (6%) required a suburethral mesh implant and two (2%) patients had an infection, 4 and 5 months after SARS, respectively.
  
  
  
  Extradural implantation of SARS seems to be an effective and safe procedure in patients with spinal cord injury and neurogenic detrusor overactivity. Neurourol. Urodynam. 35:970-974, 2016. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Urology, Hospital Pablo Tobón Uribe, Medellín, Colombia. jcasta3@gmail.com.
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Castaño-Botero
authors.affiliation: Department of Urology, Hospital Universitario 12 de Octubre, Madrid, Spain.
authors.forename: Irma Amparo
authors.initials: IA
authors.lastname: Ospina-Galeano
authors.affiliation: Department of Urology, Hospital del Trabajador, Santiago de Chile, Chile.
authors.forename: Reynaldo
authors.initials: R
authors.lastname: Gómez-Illanes
authors.affiliation: Department of Urology, Hospital Pablo Tobón Uribe, Medellín, Colombia.
authors.forename: Adrian
authors.initials: A
authors.lastname: Lopera-Toro
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy / Q000009:adverse effects / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D007796:Laminectomy; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D019051:Rhizotomy; D012445:Sacrococcygeal Region; D013119:Spinal Cord Injuries / Q000150:complications* / Q000628:therapy*; D013126:Spinal Nerve Roots; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology; D053201:Urinary Bladder, Overactive / Q000209:etiology* / Q000628:therapy*; D014549:Urinary Incontinence / Q000209:etiology / Q000628:therapy
keywords: extradural implantation; neurogenic detrusor overactivity; posterior rhizotomy; spinal cord injury