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[Posterior sacral root neuromodulation in the treatment of chronic urinary dysfunction]
A I Linares Quevedo1, M A Jiménez Cidre, E Fernández Fernández
1Unidad de Urodinámica, Servicio de Urología, Hospital Ramón y Cajal, Madrid.
Objectives:
To describe the effectiveness of sacral root neuromodulation in ameliorating symptoms of refractory voiding disfunction in our center.
Material And Methods:
During the period from december 1998 throught december 2001, 31 Percutaneous Nerve Evaluation (PNE) was performed to 20 patients with refractory voiding dysfunction; a sacral nerve stimulation device was implanted in 10 patients (8 female, 2 male). The median age was 49 years. Refractory voiding dysfunction included: mixed disorders (30%), idiopathic nonobstructive chronic urinary retention (20%), urgency/frequency (20%), faecal and urinary incontinence with absence of sphincter defect (20%) and frequency (10%).
Results:
The 2 patients with frequency/urgency decreased their symptoms more than 50%, bladders were emptied without post-void residual urine in 2 patients with urinary retention, faecal and urinary incontinence in 2 patients and mixed disorders in other 3, reduced their symptoms more than 90% without residual urine. The frequency improved more than 50% in 1 patient.
Conclusions:
Sacral Root Neuromodulation is a successful treatment in some cases of idiopathic chronic micturition dysfunction which don't respond to pharmacotheraphy or bladder retraining. The effects of neuromodulation are long-lasting and associated morbidity is low.