Bilateral S3 nerve stimulation, a minimally invasive alternative treatment for postoperative stress incontinence after implantation of an anterior root stimulator with posterior rhizotomy : a preliminary observation

• Published in: Spinal cord Vol. 38; no. 4; pp. 262 - 264
• Main Authors: EVERAERT, K, DERIE, A, VAN LAERE, M, VANDEKERCKHOVE, T
• Format: Journal Article
• Language: English
• Published: London Nature Publishing 01.04.2000; Nature Publishing Group
• Subjects: Adult; Biological and medical sciences; Electric Stimulation Therapy - methods; Electrodes, Implanted - adverse effects; Humans; Male; Medical sciences; Nervous system (semeiology, syndromes); Nervous system as a whole; Neurology; Postoperative Complications - therapy; Rhizotomy - adverse effects; Spinal Cord Injuries - complications; Spinal Nerve Roots - physiopathology; Spinal Nerve Roots - surgery; Treatment Outcome; Urinary Incontinence, Stress - etiology; Urinary Incontinence, Stress - therapy; Urination; Human; Nervous system diseases; Urinary system disease; Motor system disorder; Anterior spinal root; Instrumentation therapy; Bilateral; Urinary tract disease; Sacral root; Case study; Urinary incontinence; Voiding dysfunction; Instrumental stimulation; Paraplegia; Treatment; Detrusor sphincter dyssynergia; Surgery; Posterior; Neurogenic bladder; Bladder disease; Rhizotomy; Neurological disorder
• ISSN: 1362-4393; 1476-5624
• DOI: 10.1038/sj.sc.3100984

A preliminary report. Urinary stress incontinence following implantation of an anterior root stimulator and a posterior rhizotomy is a rare complication which is difficult to treat. It is seen in patients with an open bladder neck (T9-L2 lesion). An artificial urinary sphincter is a possible treatment for this condition but has a higher failure rate in patients with neurogenic bladder disease and could complicate micturition. Ghent, Belgium. A male paraplegic patient (T9, complete lesion) aged 36 was suffering from severe urinary incontinence due to detrusor hyperreflexia. Preoperatively the bladder neck was closed on cystography. Following implantation (6/95) of an intradural anterior root stimulator with posterior rhizotomy, severe urinary stress incontinence presented. Bilateral S3 foramen leads were implanted and connected to a pulse generator. The patient has been continent with continuous stimulation of both S3 roots for 4 years, and no fatigue of the levator muscles has been seen. Preoperative urodynamics are compared to results 3 years postoperatively. Bilateral S3 stimulation is a feasible and minimally invasive treatment of urinary stress incontinence following implantation of an anterior root stimulator.