World Journal of Urology

, Volume 9, Issue 3, pp 138–141 | Cite as

Neuromodulation of voiding dysfunction and pelvic pain

  • W. F. Thon
  • L. S. Baskin
  • U. Jonas
  • E. A. Tanagho
  • R. A. Schmidt
Article

Summary

Neuromodulation of sacral roots provides an alternative mode of therapy for patients presenting with voiding dysfunctions and chronic pelvic pain. Physiologically, this is accomplished by intervention in the neuronal pathways of micturition via sacral nerve-root electrical stimulation. Preoperative evaluation using temporary percutaneous sacral root stimulation selects the patients who are most likely to benefit from permanent electrode implantation. To date, no evidence of peripheral nerve damage has been recorded. Our experience with >1500 percutaneous tests and 150 permanent foramen implant procedures documents the safety and efficacy of this technique.

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References

  1. 1.
    Agnew WF, McCreery DB, Yuen TGH, Bullara LA (1989) Histologic and physiologic evaluation of electrically stimulated peripheral nerve. Consideration for the selection of parameters. Ann Biomed Eng 17:39–60Google Scholar
  2. 2.
    Auro CG de, Schmidt RA, Tanagho EA (1982) Neural pathways to lower urinary tract identified by retrograde axonal transport of horseradish peroxidase. Urology 19:290–295Google Scholar
  3. 3.
    Jonas U, Heine JP, Tanagho EA (1975) Studies on the feasibility of urinary bladder evacuation by direct spinal cord stimulation: I. Parameters of most effective stimulation. Invest Urol 13:142–150Google Scholar
  4. 4.
    Juenemann KP, Lue TF, Schmidt RA, Tanagho EA (1988) Clinical significance of sacral and pudendal nerve anatomy. J Urol 139:74–80Google Scholar
  5. 5.
    Tanagho ET, Schmidt RA (1988) Electrical stimulation in the clinical management of the neurogenic bladder. J Urol 140:1331–1339PubMedGoogle Scholar
  6. 6.
    Nashold BSJ, Goldner JL, Mullen JB, Bright DS (1982) Long-term pain control by direct peripheral nerve stimulation. J Bone Joint Surg [Am] 64:1–10Google Scholar
  7. 7.
    Schmidt RA (1983) Neural prostheses and bladder control. Eng Med Biol 2:31–36Google Scholar
  8. 8.
    Schmidt RA (1986) Advances in genitourinary neurostimulation. Neurosurgery 18(6):1041–1044Google Scholar
  9. 9.
    Schmidt RA, Bruschini H, Tanagho EA (1979) Urinary bladder and sphincter responses to stimulation of dorsal and ventral sacral roots. Invest Urol 16:300–304Google Scholar
  10. 10.
    Schmidt RA, Bruschini H, Gool J van, Tanagho EA (1979) Micturition and the male genitourinary response to sacral root stimulation. Invest Urol 17:125–129Google Scholar
  11. 11.
    Schmidt RA, Tanagho EA (1979) Feasibility of controlled micturition through electrical stimulation. Urol Int 34:199–230Google Scholar
  12. 12.
    Thüroff JW, Bazeed MA, Schmidt RA, Luu DH, Tanagho EA (1982) Regional topography of spinal cord neurons innervating pelvic floor musculature and bladder neck in the dog: A study by combined horseradish peroxidase histochemistry and autoradiography. Urol Int 37:110–120Google Scholar
  13. 13.
    Thüroff JW, Schmidt RA, Bazeed MA, Tanagho EA (1983) Chronic stimulation of the sacral roots in dogs. Eur Urol 9:102–108Google Scholar
  14. 14.
    Yuen TGH, Agnew WF, Bullara LA (1984) Histopathological evaluation of dog sacral nerve following chronic electromicturition. Neurosurgery 14:449–455Google Scholar

Copyright information

© Springer-Verlag 1991

Authors and Affiliations

  • W. F. Thon
    • 1
  • L. S. Baskin
    • 2
  • U. Jonas
    • 1
  • E. A. Tanagho
    • 2
  • R. A. Schmidt
    • 2
  1. 1.Department of UrologyHannover Medical SchoolHannover 1Federal Republic of Germany
  2. 2.Department of UrologyUniversity of California School of MedicineSan FranciscoUSA

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