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[Peripheral nerve evaluation:indications, technique and results].

S Arlandis Guzmán1, J M Alapont Alacreu, M A Bonillo García

  • 1Servicio de Urología, Hospital Universitario La Fe, Valencia.

Actas Urologicas Espanolas
|August 27, 2003
PubMed
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Peripheral Nerve Evaluation (PNE) helps select patients for sacral nerve stimulation, a treatment for chronic voiding dysfunction. This well-tolerated outpatient procedure identifies suitable candidates for permanent implantation, improving lower urinary tract symptoms.

Area of Science:

  • Neurology
  • Urology
  • Medical Devices

Background:

  • Sacral nerve neuromodulation offers a novel treatment for chronic voiding dysfunction (CVD).
  • Electrical stimulation of sacral roots aims to rebalance micturition reflexes.
  • Peripheral Nerve Evaluation (PNE) is crucial for assessing sacral nerve function and patient suitability for neuromodulation.

Purpose of the Study:

  • To evaluate the efficacy and safety of Peripheral Nerve Evaluation (PNE) in patients with chronic voiding dysfunction.
  • To determine the role of PNE in selecting appropriate candidates for sacral nerve stimulation.
  • To assess the tolerability and complication rates associated with PNE.

Main Methods:

  • Performed 43 PNE procedures in 28 patients diagnosed with various forms of CVD, including Urinary Urge Incontinence (UUI), Urgency-Frequency Syndrome (UFS), Dysfunctional Voiding (DV), and mixed syndromes.

Related Experiment Videos

  • Assessed sensory and motor responses to electrical stimulation.
  • Monitored for lead migration and evaluated clinical outcomes after a period of temporary stimulation.

    • Main Results:

    • All acute stimulations demonstrated positive sensory and motor responses.
    • Premature lead migration occurred in 18.6% of PNE procedures.
    • Good clinical results (>50% symptom reduction) were observed in 53.8% of UUI patients, 40% of UFS patients, 14.2% of DV patients, and 33.3% of mixed syndrome patients.
    • 39.2% of patients with CVD were selected for permanent sacral nerve stimulation implantation.

    Conclusions:

    • PNE is an essential first step in selecting patients for sacral nerve stimulation therapy.
    • PNE accurately identifies suitable candidates for permanent implantation.
    • The PNE technique is easy to perform, well-tolerated, and can be conducted on an outpatient basis with minimal complications.