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Related Experiment Videos

Selecting patients for sacral nerve stimulation.

Steven W Siegel1

  • 1Center for Continence Care, Metropolitan Urologic Specialists, 360 Sherman Ave, Suite 450, St. Paul, MN 55102, USA.

The Urologic Clinics of North America
|February 9, 2005
PubMed
Summary
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Sacral neuromodulation (SNS) patient selection should focus on voiding behaviors and pelvic floor muscle function, not organ labels. A successful trial stimulation is the best indicator for selecting patients with chronic, life-altering voiding complaints.

Area of Science:

  • Urology
  • Neurology
  • Physical Therapy

Background:

  • Patient selection for sacral neuromodulation (SNS) is often empiric.
  • Current approaches may not adequately address the underlying causes of voiding dysfunction.

Purpose of the Study:

  • To redefine patient selection criteria for sacral neuromodulation.
  • To emphasize the role of voiding behaviors and pelvic floor muscle function in candidate selection.

Main Methods:

  • Consideration of voiding dysfunction based on behaviors and pelvic floor muscle function.
  • Identification of prime candidates including those with intractable urinary frequency, urgency, urge incontinence, or idiopathic urinary retention.
  • Evaluation for high-tone pelvic floor muscle dysfunction via physical examination and pelvic-floor EMG.

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Main Results:

  • A successful trial stimulation is the most reliable indicator for patient selection.
  • Routine diagnostic testing with trial stimulation is recommended for chronic, life-altering voiding complaints unresponsive to conventional treatments.

Conclusions:

  • Shift focus from organ-based labels to functional assessments for SNS patient selection.
  • Integrate pelvic floor muscle function evaluation into the diagnostic process.
  • Utilize trial stimulation as a standard diagnostic tool for refractory voiding dysfunction.