STUDY OBJECTIVE: To report about the laparoscopic implantation of neuroprothesis to the pudendal nerve (PN) for treatment for non-neurogenic bladder overactivity.
DESIGN: Case series.
DESIGN: Classification: Level I.
SETTING: Tertiary referral unit specialized in advanced gynaecological surgery and neuropelveology.
PATIENTS: 14 consecutive male and female patients
INTERVENTIONS: Laparoscopic implantation of electrode to endopelvic portion of the pudendal nerve (PN) for pudendal neuromodulation.
MEASUREMENTS AND MAIN RESULTS: All procedures were performed successfully by laparoscopy without any complications. The mean operative time for the entire procedure was 18 minutes. After a successfully test-phase of external stimulation, 11 patients underwent implantation of permanent generator (78.57%). These patients had presented a reduction of micturition frequency from 25 per day in average (±11.7;13-50) to 10.18 (±2.7; 7-15) at final evaluation (mean follow-up 18 months, range 9-49 months). Nocturia decreased from 5.82 (±4.2;3-18) to 2.18 (±1.08; 1-5) micturitions per night. Cystometric bladder capacities increased from a mean of 159ml (±53; 80-230ml) to 312ml (±104.9;160ml-500ml). Mean incontinence episodes at the initial evaluation based on a 3-days voiding diary were 8.1 comparing; at final evaluation 6 patients were completely dry. Average pads used per days reduced from 7.3 (±4.2) to 1.6 (±2.3). No any lead dislocation or migration did occurred.
CONCLUSIONS: Laparoscopic implantation of neuroprothesis to the PN is an effective, safe and reproducible day-procedure for treatment for intractable non-neurogenic OAB with UUI.
Written by:
Possover M. Are you the author?
Department of Surgical Gynecology & Neuropelveology, Hirslanden Clinic, CH- 8032 Zürich.
Reference: J Minim Invasive Gynecol. 2014 Apr 16. pii: S1553-4650(14)00245-3.
doi: 10.1016/j.jmig.2014.03.026
PubMed Abstract
PMID: 24747099
UroToday.com Overactive Bladder (OAB) Section
