Purpose: The Italian Register was created in February 1997 to collect the national results of sacral neuromodulation. All Italian centers at which sacral neuromodulation is performed were invited to participate in our study. We present the results from retrospective and prospective registers.
Materials And Methods: A total of 196 patients underwent permanent implantation of sacral neuromodulation and were enrolled in the Italian register. There were 18 males and 75 females in the retrospective, and 28 males and 75 females in the prospective studies. Student's t test was used to compare paired values, and the Wilcoxon rank sum and nonparametric tests were used when necessary.
Results: Mean incontinent episodes daily plus or minus standard deviation for patients with detrusor instability went from 5.4 +/- 3.9 to 1.1 +/- 1.6 (median 5 and 0, respectively) at 12-month followup (p <0.001). For idiopathic retention average residual volume decreased from 277 to 108 cc (median 287 and 80, respectively), and 50% of patients stopped catheterization and another 13% catheterized once daily at 1-year after implantation. With neurogenic voiding disturbances, the results fluctuated with time from a minimum of 33% to a maximum 66% of patients who did not catheterize at 6-month followup and 12 months after implantation, respectively. At 12-month followup, 50% of patients with hyperreflexia had less than 1 incontinent episode daily. The problem was completely solved in 66% of patients in the retention group. Of patients in the urge incontinent population 39% were completely dry and 23% had less than 1 incontinent episode daily.
Conclusions: Sacral neuromodulation is effective therapy for treating lower urinary tract symptoms resistant to less invasive therapy.
Download full-text PDF |
Source |
---|
Urogynecology (Phila)
February 2025
From the Departments of Gynecology and Obstetrics.
Importance: Patients deciding between advanced therapies for overactive bladder syndrome may be interested to know the likelihood of treatment crossover after sacral neuromodulation, intradetrusor OnabotulinumtoxinA, or percutaneous tibial nerve stimulation. Treatment crossover was defined as a switch from one advanced therapy to another.
Objectives: The aim of this study was to estimate the rate of treatment crossover after each advanced therapy for nonneurogenic overactive bladder syndrome.
Urogynecology (Phila)
February 2025
From the University of Connecticut Health Center, Farmington, CT.
World J Gastroenterol
January 2025
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Augusta University, Augusta, GA 30912, United States.
Fecal incontinence is a common condition that can significantly impact patients' quality of life. Obstetric anal sphincter injury and anorectal surgeries are common etiologies. Endoanal ultrasound and anorectal manometry are important diagnostic tools for evaluating patients.
View Article and Find Full Text PDFUrologie
January 2025
Neuro-Urologie, Schweizer Paraplegiker-Zentrum, Guido A. Zäch-Straße 1, 6207, Nottwil, Schweiz.
A spinal cord injury (SCI) leads to neurogenic lower urinary tract dysfunction (NLUTD), which, if left untreated, can result not only in urinary incontinence and an increased risk of urinary tract infections and kidney dysfunction but may also pose a vital threat to people with SCI. Comprehensive neurourological assessments, including patient history and combined video urodynamics, are essential to accurately classify dysfunction and establish therapeutic strategies. Treatment options include, among others, medications for detrusor regulation, intermittent catheterization, and, if necessary, surgical interventions from intradetrusor botulinum toxin A injections to sacral deafferentation.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
Aging + Cardiovascular Discovery Center, Department of Biomedical Education and Data Science, Lewis Katz School of Medicine of Temple University, Philadelphia, PA 19140, USA.
We have demonstrated in human cadavers and canines that nerve transfer to bladder vesical nerve branches is technically feasible for bladder reinnervation after nerve injury. We further clarify here that sacral (S) ventral rami contribute to these vesical branches in 36 pelvic sides (in 22 human cadavers). Gross post-mortem visualization and open anterior abdominal approaches were used, as was micro-CT of sacral nerve bundles, for further confirmation when needed.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!