How Does Sacral Modulation Work Best? Placement and Programming Techniques to Maximize Efficacy.
Summary of "How Does Sacral Modulation Work Best? Placement and Programming Techniques to Maximize Efficacy."
Since receiving approval from the US Food and Drug Administration in 1997, sacral neuromodulation (SNM) has become the recommended treatment of urinary urge incontinence, urgency-frequency, nonobstructive urinary retention, and fecal incontinence. The manufacturer has introduced different technical modifications while surgeons and researchers have adapted and published various innovations and alterations of the technique. This review summarizes the current knowledge and recommendations of SNM preoperative decision making, the implantation technique, and available programming parameters and algorithms based on MEDLINE research, manufacturer instructions, and the approach of an experienced neurourological team. The primary steps and technical aspects to optimize SNM efficacy were the introduction of the tined-lead electrode and the development of the InterStim II impulse generator (both developed by Medtronic, Inc., Minneapolis, MN). The initiation of the staged implantation technique for sequential evaluation and implantation with the definitive quadripolar electrode completes the treatment algorithm so that an increased responder rate of SNM for all indications can be achieved.
Affiliation
Department of Urology, Eberhard Karls Universität Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.
Journal Details
This article was published in the following journal.
Name: Current urology reports
ISSN: 1534-6285
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21710239
- DOI: http://dx.doi.org/10.1007/s11934-011-0204-2
Medical and Biotech [MESH] Definitions
Neurolinguistic Programming
A set of models of how communication impacts and is impacted by subjective experience. Techniques are generated from these models by sequencing of various aspects of the models in order to change someone's internal representations. Neurolinguistic programming is concerned with the patterns or programming created by the interactions among the brain, language, and the body, that produce both effective and ineffective behavior.
Programming, Linear
A technique of operations research for solving certain kinds of problems involving many variables where a best value or set of best values is to be found. It is most likely to be feasible when the quantity to be optimized, sometimes called the objective function, can be stated as a mathematical expression in terms of the various activities within the system, and when this expression is simply proportional to the measure of the activities, i.e., is linear, and when all the restrictions are also linear. It is different from computer programming, although problems using linear programming techniques may be programmed on a computer.
Employment, Supported
Paid work for mentally or physically disabled persons, taking place in regular or normal work settings. It may be competitive employment (work that pays minimum wage) or employment with subminimal wages in individualized or group placement situations. It is intended for persons with severe disabilities who require a range of support services to maintain employment. Supported employment differs from SHELTERED WORKSHOPS in that work in the latter takes place in a controlled working environment. Federal regulations are authorized and administered by the U.S. Department of Education, Office of Special Education and Rehabilitative Services.
Antigenic Modulation
Loss of detectable antigen from the surface of a cell after incubation with antibodies. This is one method in which some tumors escape detection by the immune system. Antigenic modulation of target antigens also reduces the therapeutic effectiveness of treatment by monoclonal antibodies.
Lumbosacral Plexus
The lumbar and sacral plexuses taken together. The fibers of the lumbosacral plexus originate in the lumbar and upper sacral spinal cord (L1 to S3) and innervate the lower extremities.
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