STUDY OBJECTIVE: To show a new technique of laparoscopic implantation of electrode for stimulation of the pudendal nerve for treatment of fecal incontinence and/or OAB with urinary incontinence.
DESIGN: Step-by-step explanation of the technique using videos and pictures (educative video).
SETTING: Hyperactivity of the bladder with urinary incontinence, especially the non-neurogenic form of the condition, but also fecal incontinence may affect millions of women over the world, without any co-morbidities and in particular without any neurologic disorders or prolapsed organs. First-line conservative treatments do not always lead to sufficient improvement of the complaints and are often associated with disabling adverse effects leading to treatment failure. Electrical stimulation of the pelvic nerves has emerged as an alternative and attractive treatment for refractory cases. A novel technique of implantation of an electrode to the pudendal nerve has been developed for treatment as well of fecal incontinence as of hyperactivity of the bladder with urinary incontinence. The laparoscopic approach is the only technique that enable placement of an electrode in direct contact to the endopelvic portion of the pudendal nerve within the protection of the pelvis.
INTERVENTIONS: Laparoscopic transperitoneal implantation of a stimulation electrode to the endopelvic portion of the pudendal nerve.
CONCLUSION: This technique of transperitoneal placement of an electrode to the endopelvic portion of the pudendal nerve enables an effective, safe and reproducible day-procedure for treatment for intractable hyperactive bladder, urinary incontinence, fecal incontinence and the combination of both form of incontinences.
Written by:
Marc P. Are you the author?
Possover International Medical Center - Zuerich - Switzerland.
Reference: J Minim Invasive Gynecol. 2014 Feb 5. pii: S1553-4650(14)00059-4.
doi: 10.1016/j.jmig.2014.02.003
PubMed Abstract
PMID: 24509291
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