Sacral nerve root stimulation for lower urinary tract dysfunction: overcoming the problem of lead migration

Area of Science:

• Urology
• Biomedical Engineering
• Neurosurgery

Background:

• Sacral neuromodulation is used to treat lower urinary tract dysfunction.
• Patient selection for sacral neuromodulation involves trial stimulation of the S3 nerve root.
• Lead migration during trial stimulation can lead to test failures.

Purpose of the Study:

• To compare lead migration between two test electrodes for S3 nerve root stimulation.
• To evaluate the impact of lead migration on patient response to trial stimulation for sacral neuromodulation.

Main Methods:

• Twelve women with refractory lower urinary tract symptoms underwent peripheral nerve evaluation.
• Two electrode models (original and new) were inserted bilaterally into the S3 nerve roots.
• Lead migration was measured using lateral sacral X-rays; patient response was assessed via urodynamics and urinary diaries.

Main Results:

• The new electrode showed significantly less mean migration (4 mm) compared to the original electrode (12 mm) (P = 0.02).
• Ten out of twelve women had a positive response to trial stimulation with the new lead.
• Reduced lead migration may correlate with improved response rates.

Conclusions:

• The new electrode demonstrated reduced lead migration compared to the original model.
• Lower lead migration may contribute to higher success rates in patient selection for sacral neuromodulation.
• The new electrode has the potential to decrease test failures attributed to lead migration.