Intradural spinal stimulation approach to selection/follow-up

Summary

Thus far, the results of sacral deafferentation and implantation of an SARS carried out to achieve urinary continence and balanced bladder emptying have been quite good. All of the patients have shown appreciation for the procedure, although our experience indicates that there is a 20% chance that a repair will subsequently be necessary and a 15% chance that a second deafferentation will be required at the conal level in patients presenting with detrusor hyperreflexia. All of our subjects suffered preoperatively from an unbalanced reflex bladder and from an embarrassing reflex urinary incontinence, which could not be managed otherwise and represented a great handicap, especially for the women. In all, 18 of 20 patients have become fully continent, 1 leaks only at night and 1 suffers postoperatively from urinary stress incontinence at 6 months after SDAF. All can achieve sufficient bladder emptying by electrostimulation, and only two need additional assistance via the Credé method.