Item Number: 36663, 18262
The aim is to alter the neuro-transmission from the Spinal Centre to the Bladder
Why is it done?
- To alter the neuro-transmission from the Spinal Centre to the Bladder:
- Refractory Over Active Bladders with Urge Incontinence (OAB)
- Under Active Bladders (UAB)
- Chronic Pelvic Pain
- Faecal Incontinence
- Causative factors:
– Undetermined
– Neurogenic causes such as Multiple Sclerosis
When at least 2 anticholinergic drugs or B-adrenergic drugs have failed to have provided an improvement in symptoms of OAB
An alternative for ISC or permanent IDC for UAB
The aim was to alter the neuro-transmission from the Spinal Centre to the Bladder
This will be a trial to see if this works for you
How is it done?
- Sedation is administered
- You will be placed prone (on your stomach) with lower back and buttocks exposed
- A Needle will be placed in the S3 foramina of the sacrum and connected to an electrical current with increased frequency until the correct response is obtained
- The correct response would be puckering of the anal sphincter as well as the movement of the big toe
- The lead is then tunnelled under the skin
- The Lead is attached to an external modulator and battery.
- Pts with UAB may have permanent lead placement from the start, as effects may take up to 12 months to occur
- If you have an OAB: you should experience a marked improvement over the previous 2 weeks
- A minimal requirement of at least 50% improvement in urinary symptoms is 1required to progress to a full implant
- The Temporary leads will be removed with the external module and the permanent leads may be introduced on the next procedure
- As routine in my practice, the permanent lead is used as the temporary, therefore allowing for the exact same results as with the trial period
- The permanent battery will be placed in a pocket created under the skin with an extension of prior incision on the subsequent procedure
- Generally, a temporary lead is not done for an UAB, as the response may take up to 9-12 months
- Leads for pain are placed bilaterally and in multiple sites
Complications
- Some local discomfort may be experienced.
- Nerve stimulator may provide abnormal sensations, which your body adjusts to.
- A Representative from Medtronic will be in contact with you to check on your settings and responses.
- If after a 2 weeks period of the temporary leads have shown an improved in your bladder, consideration will be given to a permanent implant
- If no response is obtained the leads may be removed.
- NB! Each person is unique and for this reason symptoms may vary!
Copyright 2019 Dr Jo Schoeman