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512 SACRAL NEUROMODULATION FOR NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A VALUABLE TREATMENT OPTION?
Poster Session 32 NEUROMODULATION AND THE URINARY TRACT Sunday, 18 April, 14.00-15.30, Padua Room
511
AN EXPERIMENTAL SPINAL CORD INJURY MODEL TO SHOW THE OBJECTIVE EFFECTS OF CHRONIC SACRAL NEUROMODULATION
.XPVDU6.HVNLQ8.RVGDN6(UGHP653HġNLUFLRáOX/]NDUGHġ+ 1 Baskent University Hospital, Dept. of Urology, Ankara, Turkey, 2Baskent University Hospital, Dept. of Pharmacology, Ankara, Turkey Introduction & Objectives: 6SLQDOFRUGLQMXU\ 6&, DEROLVKHVYROXQWDU\FRQWURORI YRLGLQJDVZHOODVFRRUGLQDWHGXULQDU\EODGGHUXUHWKUDOVSKLQFWHUDFWLYLW\OHDGLQJWR EODGGHUVSKLQFWHUG\V\QHUJLDDQGIXQFWLRQDOREVWUXFWLRQ6DFUDOQHXURPRGXODWLRQ KDVEHHQFRQVLGHUHGDVDQHᚎHFWLYHWUHDWPHQWRSWLRQIRUYDULRXVFKURQLFYRLGLQJ G\VIXQFWLRQEXWWKHPHFKDQLVPRIDFWLRQLVQRWZHOOXQGHUVWRRG7KHDLPRIWKLV VWXG\LVWRHYDOXDWHWKHHᚎHFWRIFKURQLFQHXURPRGXODWLRQRQEODGGHUIXQFWLRQVLQ 6&, Material & Methods: )HPDOH6SUDJXH'DZOH\UDWV sJ Q ZHUHGLYLGHG LQWRIRXUJURXSVDVIROORZV &RQWUROJURXS Q VSLQDOFRUGWUDQVHFWLRQJURXS Q VSLQDOFRUGWUDQVHFWLRQVDFUDOQHXURPRGXODWLRQJURXS Q VSLQDOFRUG WUDQVHFWLRQHOHFWURGHZLUHLPSODQWDWLRQZLWKRXWVDFUDOQHXURPRGXODWLRóQ VKDP Q 6&76&7610DQG6KDPJURXSVZHUHDQDHVWKHWL]HGZLWKNHWDPLQH PJNJLS DQG[\OD]LQH PJNJLS 6SLQDOFRUGZDVFRPSOHWHO\WUDQVHFWHGDW7 s OHYHO(OHFWURGHZLUHZDVLPSODQWHGLQWR6GRUVDOIRUDPLQDLQERWKVKDPDQG 610JURXSVDQGHOHFWULFDOVWLPXODWLRQZDVSHUIRUPHGRQO\LQ610JURXSKGD\ IRUZHHNV7ZHQW\RQHGD\VDIWHUWKLVSURFHGXUHWKHEODGGHUZDVWRWDOO\UHPRYHG DQGSKDUPDFRORJLFDOO\LQYHVWLJDWHG Results: ,QLVRPHWULFFRQWUDFWLRQH[SHULPHQWV6&7LQFUHDVHGEODGGHUPXVFDULQLF FRQWUDFWLRQ UHVSRQVHV DQG 610 FRXOG QRW SUHYHQW WKLV LQFUHDVH ,Q LVRPHWULF UHOD[DWLRQ H[SHULPHQWV 6&7 GHFUHDVHG ˟ DGUHQHUJLF UHOD[DWLRQ UHVSRQVHV DQG 610 SRWHQWLDOLVHG WKH EODGGHUಬV ˟ DGUHQHUJLF UHOD[DWLRQ UHVSRQVHV 1LWULF R[LGH GLGQಬWHᚎHFWWKHUHOD[DWLRQUHVSRQVHV Conclusions: $FFRUGLQJ WR WKHVH UHVXOWV DOWHUDWLRQV LQ DGUHQHUJLF UHFHSWRUV LQ XULQDU\ EODGGHUVHHPVWREHGXHWRVDFUDOQHXURPRGXODWLRQ )XUWKHUVWXGLHV DUH UHTXLUHGWRGHPRQVWUDWHWKHDOWHUDWLRQVDWWKHOHYHORIEODGGHUUHFHSWRUVIROORZLQJ VDFUDOQHXURPRGXODWLRQ
512
SACRAL NEUROMODULATION FOR NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A VALUABLE TREATMENT OPTION?
.HVVOHU70/D)UDPERLVH'(OQHLO6)RZOHU&-.LVV*3DQQHN- 6FKXUFK%6LHYHUW.'(QJHOHU'6 1 University Hospital of Berne, Dept. of Urology, Berne, Switzerland, 2Independent Medical Researcher, St. Prex, Switzerland, 3University College London Hospitals NHS Foundation Trust, Dept. of Uro-Neurology, London, United Kingdom, 4 University Hospital Innsbruck, Dept. of Neuro-Urology, Innsbruck, Austria, 5Swiss Paraplegic Centre, Nottwil, Switzerland, 6University of Zurich, Dept. of Spinal Cord Injury Centre, Zurich, Switzerland, 7University of Tübingen, Dept. of Urology, Tübingen, Germany, 8Cantonal Hospital, Dept. of Urology, St. Gallen, Switzerland Introduction & Objectives: 7KH WUHDWPHQW RI QHXURJHQLF ORZHU XULQDU\ WUDFW G\VIXQFWLRQ /87' LVDFKDOOHQJHEHFDXVHFRQYHQWLRQDOWKHUDSLHVRIWHQIDLO6DFUDO QHXURPRGXODWLRQ 610 KDVEHFRPHDZHOOHVWDEOLVKHGWKHUDS\IRUUHIUDFWRU\QRQ QHXURJHQLF /87' EXW LWV YDOXH LQ SDWLHQWV ZLWK D QHXURORJLFDO FDXVH LV XQFOHDU 7KXVZHXQGHUWRRNDV\VWHPDWLFUHYLHZWRDVVHVVWKHHᚑFDF\DQGVDIHW\RI610 LQWKHWUHDWPHQWRISDWLHQWVZLWKQHXURJHQLF/87' Material & Methods: 7KLVV\VWHPDWLFUHYLHZZDVGRQHDFFRUGLQJWRWKH35,60$ VWDWHPHQW6WXGLHVZHUHLGHQWLᚏHGE\HOHFWURQLFVHDUFKRI3XE0HG(0%$6(DQG 6FLHQFH'LUHFW DQG E\ KDQG VHDUFK RI UHIHUHQFH OLVWV DQG UHYLHZ DUWLFOHV 610 DUWLFOHV ZHUH LQFOXGHG LI WKH\ UHSRUWHG RQ HᚑFDF\ DQGRU VDIHW\ RI WHVWHG DQGRU SHUPDQHQWO\LPSODQWHGSDWLHQWVVXᚎHULQJIURPQHXURJHQLF/87'7ZRUHYLHZHUV LQGHSHQGHQWO\ VHOHFWHG VWXGLHV DVVHVVHG WKHLU PHWKRGRORJLFDO TXDOLW\ DQG H[WUDFWHGGDWD Results: :HLQFOXGHGDUWLFOHVGHVFULELQJWKHUHVXOWVRILQGHSHQGHQWVWXGLHV 7KH OHYHO RI HYLGHQFH UDQJHG IURP E WR DFFRUGLQJ WR WKH 2[IRUG &HQWUH IRU (YLGHQFHEDVHG PHGLFLQH +DOI Q RI WKH LQFOXGHG VWXGLHV UHSRUWHG GDWD RQ ERWKWHVWSKDVHDQGSHUPDQHQW610WKHUHPDLQLQJZHUHFRQᚏQHGWRWHVWSKDVH Q RUSHUPDQHQW610 Q 610WHVWLQJZDVVXFFHVVIXOLQ RI WKHSDWLHQWVDQG KDGDQDGYHUVHHYHQW QRQHUHTXLUHGVXUJLFDOUHYLVLRQ 2YHUDOOSDWLHQWVXQGHUZHQWQHXURPRGXODWRULPSODQWDWLRQDQG610ZDVVWLOO VXFFHVVIXOLQ DWDPHDQODVWIROORZXSRIPRQWKV &, 'XULQJIROORZLQJQHXURPRGXODWRULPSODQWDWLRQ RIWKHSDWLHQWVKDGDQ DGYHUVHHYHQWDQG XQGHUZHQWVXUJHU\EHFDXVHRIDGYHUVHHYHQW Conclusions: 7KHUHLVOLPLWHGHYLGHQFHLQGLFDWLQJWKDW610LVHᚎHFWLYHDQGVDIH IRUWKHWUHDWPHQWRISDWLHQWVZLWKQHXURJHQLF/87'7KHQXPEHU RILQYHVWLJDWHG SDWLHQWVLVORZDQGWKHUHLVDFRPSOHWHODFNRIUDQGRPLVHGFRQWUROOHGWULDOV7KXV ZHOOGHVLJQHGDGHTXDWHO\SRZHUHGVWXGLHVDUHQHHGHGEHIRUHPRUHZLGHVSUHDG XVHRI610IRUQHXURJHQLF/87'FDQEHUHFRPPHQGHG
Eur Urol Suppl 2010;9(2):178
513
SACRAL ROOT STIMULATION FOR TREATMENT OF URINARY RETENTION: A NOVEL INTRACANALAR APPROACH USING SELF SIZING NERVE CUFF ELECTRODES. TECHNIQUE DESCRIPTION AND PRELIMINARY RESULTS
%HUWDSHOOH039RWWHUR06TXLQWRQH/&DURQH5&DPSV7 6DOD]]DUL6*LDUGLHOOR* 1 Azienda Ospedaliera CTO/M.Adelaide, Dept. of Neurology, Turin, Italy, 2 Medtronic Bakken Research Centre, Dept. of Research, Maastricht, The Netherlands, 3Medtronic Italia, Dept. of Research, Sesto San Giovanni, Italy Introduction & Objectives: $PDMRUSRLQWLQ6DFUDO1HUYH6WLPXODWLRQ 616 WR WUHDWXULQDU\UHWHQWLRQLVWRWDUJHWQHXUDOVWUXFWXUHVZKHUHGHSRODUL]DWLRQKDVWREH LQGXFHG:HFRQVLGHUVDFUDOURRWVVWLPXODWLRQ 656 LQVLGHWKHVSLQDOFDQDOE\FXᚎ HOHFWURGHVDURXQG6DVDIHUDQGPRUHHᚎHFWLYHDSSURDFK Material & Methods: 7KH LPSODQW VWDUWV ZLWK WHVWLQJ QHHGOHV LQVHUWHG LQ 6 IRUDPLQD DIWHUFXWDQHRXVLQFLVLRQDERYHVDFUDOVSLQRXVSURFHVVHVDQGPXVFXODU GLVVHFWLRQ6VSLQRVDLVUHPRYHGDQGWKHFDQDORSHQHGE\ಯZLQJHGODPLQHFWRP\ರ WRZDUGV HDFK 6 IRUDPHQ 6 URRW LV LGHQWLᚏHG E\ VWLPXODWLRQ DQG D WULSRODU FXᚎ HOHFWURGH 0HGWURQLF0RGHO LVZUDSSHGDURXQGLW7KHHOHFWURGHLVVFUHZHG WRWKHVDFUXPWXQQHOOHGWRWKHᚐDQNDQGFRQQHFWHGWRDEXWWRFNVWLPXODWRU)URP $SULOWR2FWREHU SDWLHQWVXQGHUZHQW6562IWKHIHPDOHSDWLHQWVZLWK XULQDU\UHWHQWLRQKDGIXQFWLRQDOREVWUXFWLRQDQGIDLOHG616KDGFRQFRPLWDQW VHYHUHERZHOFRQVWLSDWLRQGXHWRSHULSKHUDOQHXURSDWK\KDGVHYHUH1HXURJHQLF 2YHUDFWLYH%ODGGHU 12$% LQFRPSOHWHWUDXPDWLFSDUDSOHJLDDQGKDGSUHYLRXV UDGLFDOSHOYLFVXUJHU\2IWKHPDOHSDWLHQWVKDG12$%LQFRPSOHWHWUDXPDWLF SDUDSOHJLDDQGKDGXULQDU\UHWHQWLRQLQ+,9SHULSKHUDOQHXURSDWK\ Results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sWRsFP+2 Conclusions: ,Q616SURFHGXUHZLWKRSHQRUSHUFXWDQHRXVHOHFWURGHSODFHPHQW TXDGULSRODU OHDG LV QRW FORVHG WR WKH VDFUDO QHUYH EHFDXVH RI VDFUDO SLULIRUPLV PXVFOH DWWDFKPHQW IDW DQG YHVVHOV 7KH VLWH RI VWLPXODWLRQ RXW RI WKH VSLQDO FDQDO DQG WKH ODFN RI WLJKW FRQWDFW ZLWK QHUYRXV VWUXFWXUH PLJKW EH WKH UHDVRQ IRUWKHSHULRGLFDOSDUDPHWHUVFKDQJHVDQGWKHORVVRIHᚑFDF\LQWLPHQDPHO\LQ EODGGHUYRLGLQJG\VIXQFWLRQV(OHFWURGHSODFHPHQWDWWKHUDGLFXODUVLWHDOORZVORZ YROWDJHVWLPXODWLRQDQGUHGXFHVSHULRGLFDOSDUDPHWHUVFKDQJHV7KHJRRGUHVXOWV LQ FRPSOHWH XULQDU\ UHWHQWLRQ GXH WR IXQFWLRQDO REVWUXFWLRQ ZLWK IDLOHG 616 DUH HQFRXUDJLQJ6XUJLFDOLPSODQWRIWULSRODUFXᚎURRWHOHFWURGHVLVDVDIHSURFHGXUHWKDW GRHVQRWUHTXLUHQHXURVXUJLFDOVNLOOVDQGVHHPVWRSURYLGHFRQVLVWHQWVWLPXODWLRQ WRWKHQHUYRXVWLVVXH
514
TREATMENT OF NEUROGENIC OVERACTIVE BLADDER (NOAB) IN INCOMPLETE LESIONS BY LOW FREQUENCY CHRONIC PUDENDAL NERVE STIMULATION (CPNS): LONG TERM FOLLOW-UP
6SLQHOOL0=DQROOR/&LWHUL00DODJXWL67DUDQWROD- Niguarda Hospital Milan, Alberto Zanollo Center, Milan, Italy Introduction & Objectives: 7KH HᚎHFWV VDFUDO QHXURPRGXODWLRQ LQ RYHUDFWLYH QHXURJHQLFEODGGHULQ6&,SDWLHQWGXHWRLQFRPSOHWHOHVLRQVKRZVORQJWHUPSRRU UHVXOWV3XGHQGDOQHUYHFKURQLFHOHFWURVWLPXODWLRQXVLQJDTXDGULSRODUOHDGVHHPV WREHSURPLVLQJLQORQJWHUPH[SHULHQFHLQREWDLQLQJDODUJHUFDSDFLW\DQGLQKLELWLRQ RIEODGGHUFRQWUDFWLRQEXWEHVWUHVXOWVDUHREWDLQHGLQLQFRPSOHWHOHVLRQV6WDUWLQJ IURPPD\ZHGHᚏQHGDPHWKRGWRSHUIRUPFKURQLFSXGHQGDOQHUYHVWLPXODWLRQ XVLQJWLQHGOHDGDGRSWHGIRUVDFUDOQHXURPRGXODWLRQ$IWHUDSUHOLPLQDU\H[SHULHQFH LQIHZSDWLHQWVZLWKDSHULQHDODSSURDFKZHDGRSWHGDFRGLᚏHGPHWKRGXVLQJD SRVWHULRUDSSURDFKEDVHGRQERQ\ODQGPDUNVDQGQHXURSK\VLRORJLFDOPRQLWRULQJ Material & Methods: 3XGHQGDOQHUYHVWLPXODWLRQDQGWKHHOHFWURGHSODFHPHQWLV GRQHGXULQJWKHQHXURSK\VLFRORJLFDOPRQLWRULQJXVLQJWKHOHDGDQGWKHLQWURGXFHU NLWDYDLODEOHIRUPLQLPDOO\LQYDVLYHLPSODQWRIVDFUDOQHXURPRGXODWLRQ6LQFH SWVZLWKVDFUDODUHDG\VIXQFWLRQIHPDOH PDOHPHDQDJHs\UV 12$% LGLRSDWKLF 2$% UHWHQWLRQ VSKLQFWHULF GHᚏFLW FRQVWLSDWLRQ 3DLQIXOEODGGHUV\QGURPHZHUHVXEPLWWHGWRWKHSURFHGXUH,Q12$%SDWLHQWV ZHUHUHIUDFWRU\WRDQWLPXVFDULQLFGUXJVDQGEHIRUHGHFLGLQJWRSHUIRUPERWXOLQXP WR[LQ $ %7; LQMHFWLRQ 3XGHQGDO QHUYH VWLPXODWLRQ ZDV FRQVLGHUHG 6WLPXODWLRQ ZDV GHOLYHUHG E\ ELSRODU FRQᚏJXUDWLRQ += PVHF LQWHQVLW\ RI VWLPXODWLRQ DW VXEMHFWLYH WKUHVKROG &OLQLFDO HYDOXDWLRQ ZHUH EDVHG RQ EODGGHU GLDU\ DQG F\VWRPHWU\ Results: 2XWRISWVVXEPLWWHGWRWKHVWVWDJHRILPSODQW SWVUHDFKHGWKHQG VWDJHZHUHH[SODQWHGDQGWUHDWHGE\%7;,QFRQWLQHQFHHSLVRGHVUHGXFHGIURP sDWEDVHOLQHWRs S LQORQJWHUPIROORZXS PHDQPRQWKVUDQJH PHDQFDSDFLW\LQFUHDVHGIURPsWRs S Conclusions: $VLQSUHYLRXVUHSRUWVSXGHQGDOQHUYHVWLPXODWLRQUHSUHVHQWVDQHZ
511
AN EXPERIMENTAL SPINAL CORD INJURY MODEL TO SHOW THE OBJECTIVE EFFECTS OF CHRONIC SACRAL NEUROMODULATION
.XPVDU6.HVNLQ8.RVGDN6(UGHP653HġNLUFLRáOX/]NDUGHġ+ 1 Baskent University Hospital, Dept. of Urology, Ankara, Turkey, 2Baskent University Hospital, Dept. of Pharmacology, Ankara, Turkey Introduction & Objectives: 6SLQDOFRUGLQMXU\ 6&, DEROLVKHVYROXQWDU\FRQWURORI YRLGLQJDVZHOODVFRRUGLQDWHGXULQDU\EODGGHUXUHWKUDOVSKLQFWHUDFWLYLW\OHDGLQJWR EODGGHUVSKLQFWHUG\V\QHUJLDDQGIXQFWLRQDOREVWUXFWLRQ6DFUDOQHXURPRGXODWLRQ KDVEHHQFRQVLGHUHGDVDQHᚎHFWLYHWUHDWPHQWRSWLRQIRUYDULRXVFKURQLFYRLGLQJ G\VIXQFWLRQEXWWKHPHFKDQLVPRIDFWLRQLVQRWZHOOXQGHUVWRRG7KHDLPRIWKLV VWXG\LVWRHYDOXDWHWKHHᚎHFWRIFKURQLFQHXURPRGXODWLRQRQEODGGHUIXQFWLRQVLQ 6&, Material & Methods: )HPDOH6SUDJXH'DZOH\UDWV sJ Q ZHUHGLYLGHG LQWRIRXUJURXSVDVIROORZV &RQWUROJURXS Q VSLQDOFRUGWUDQVHFWLRQJURXS Q VSLQDOFRUGWUDQVHFWLRQVDFUDOQHXURPRGXODWLRQJURXS Q VSLQDOFRUG WUDQVHFWLRQHOHFWURGHZLUHLPSODQWDWLRQZLWKRXWVDFUDOQHXURPRGXODWLRóQ VKDP Q 6&76&7610DQG6KDPJURXSVZHUHDQDHVWKHWL]HGZLWKNHWDPLQH PJNJLS DQG[\OD]LQH PJNJLS 6SLQDOFRUGZDVFRPSOHWHO\WUDQVHFWHGDW7 s OHYHO(OHFWURGHZLUHZDVLPSODQWHGLQWR6GRUVDOIRUDPLQDLQERWKVKDPDQG 610JURXSVDQGHOHFWULFDOVWLPXODWLRQZDVSHUIRUPHGRQO\LQ610JURXSKGD\ IRUZHHNV7ZHQW\RQHGD\VDIWHUWKLVSURFHGXUHWKHEODGGHUZDVWRWDOO\UHPRYHG DQGSKDUPDFRORJLFDOO\LQYHVWLJDWHG Results: ,QLVRPHWULFFRQWUDFWLRQH[SHULPHQWV6&7LQFUHDVHGEODGGHUPXVFDULQLF FRQWUDFWLRQ UHVSRQVHV DQG 610 FRXOG QRW SUHYHQW WKLV LQFUHDVH ,Q LVRPHWULF UHOD[DWLRQ H[SHULPHQWV 6&7 GHFUHDVHG ˟ DGUHQHUJLF UHOD[DWLRQ UHVSRQVHV DQG 610 SRWHQWLDOLVHG WKH EODGGHUಬV ˟ DGUHQHUJLF UHOD[DWLRQ UHVSRQVHV 1LWULF R[LGH GLGQಬWHᚎHFWWKHUHOD[DWLRQUHVSRQVHV Conclusions: $FFRUGLQJ WR WKHVH UHVXOWV DOWHUDWLRQV LQ DGUHQHUJLF UHFHSWRUV LQ XULQDU\ EODGGHUVHHPVWREHGXHWRVDFUDOQHXURPRGXODWLRQ )XUWKHUVWXGLHV DUH UHTXLUHGWRGHPRQVWUDWHWKHDOWHUDWLRQVDWWKHOHYHORIEODGGHUUHFHSWRUVIROORZLQJ VDFUDOQHXURPRGXODWLRQ
512
SACRAL NEUROMODULATION FOR NEUROGENIC LOWER URINARY TRACT DYSFUNCTION: A VALUABLE TREATMENT OPTION?
.HVVOHU70/D)UDPERLVH'(OQHLO6)RZOHU&-.LVV*3DQQHN- 6FKXUFK%6LHYHUW.'(QJHOHU'6 1 University Hospital of Berne, Dept. of Urology, Berne, Switzerland, 2Independent Medical Researcher, St. Prex, Switzerland, 3University College London Hospitals NHS Foundation Trust, Dept. of Uro-Neurology, London, United Kingdom, 4 University Hospital Innsbruck, Dept. of Neuro-Urology, Innsbruck, Austria, 5Swiss Paraplegic Centre, Nottwil, Switzerland, 6University of Zurich, Dept. of Spinal Cord Injury Centre, Zurich, Switzerland, 7University of Tübingen, Dept. of Urology, Tübingen, Germany, 8Cantonal Hospital, Dept. of Urology, St. Gallen, Switzerland Introduction & Objectives: 7KH WUHDWPHQW RI QHXURJHQLF ORZHU XULQDU\ WUDFW G\VIXQFWLRQ /87' LVDFKDOOHQJHEHFDXVHFRQYHQWLRQDOWKHUDSLHVRIWHQIDLO6DFUDO QHXURPRGXODWLRQ 610 KDVEHFRPHDZHOOHVWDEOLVKHGWKHUDS\IRUUHIUDFWRU\QRQ QHXURJHQLF /87' EXW LWV YDOXH LQ SDWLHQWV ZLWK D QHXURORJLFDO FDXVH LV XQFOHDU 7KXVZHXQGHUWRRNDV\VWHPDWLFUHYLHZWRDVVHVVWKHHᚑFDF\DQGVDIHW\RI610 LQWKHWUHDWPHQWRISDWLHQWVZLWKQHXURJHQLF/87' Material & Methods: 7KLVV\VWHPDWLFUHYLHZZDVGRQHDFFRUGLQJWRWKH35,60$ VWDWHPHQW6WXGLHVZHUHLGHQWLᚏHGE\HOHFWURQLFVHDUFKRI3XE0HG(0%$6(DQG 6FLHQFH'LUHFW DQG E\ KDQG VHDUFK RI UHIHUHQFH OLVWV DQG UHYLHZ DUWLFOHV 610 DUWLFOHV ZHUH LQFOXGHG LI WKH\ UHSRUWHG RQ HᚑFDF\ DQGRU VDIHW\ RI WHVWHG DQGRU SHUPDQHQWO\LPSODQWHGSDWLHQWVVXᚎHULQJIURPQHXURJHQLF/87'7ZRUHYLHZHUV LQGHSHQGHQWO\ VHOHFWHG VWXGLHV DVVHVVHG WKHLU PHWKRGRORJLFDO TXDOLW\ DQG H[WUDFWHGGDWD Results: :HLQFOXGHGDUWLFOHVGHVFULELQJWKHUHVXOWVRILQGHSHQGHQWVWXGLHV 7KH OHYHO RI HYLGHQFH UDQJHG IURP E WR DFFRUGLQJ WR WKH 2[IRUG &HQWUH IRU (YLGHQFHEDVHG PHGLFLQH +DOI Q RI WKH LQFOXGHG VWXGLHV UHSRUWHG GDWD RQ ERWKWHVWSKDVHDQGSHUPDQHQW610WKHUHPDLQLQJZHUHFRQᚏQHGWRWHVWSKDVH Q RUSHUPDQHQW610 Q 610WHVWLQJZDVVXFFHVVIXOLQ RI WKHSDWLHQWVDQG KDGDQDGYHUVHHYHQW QRQHUHTXLUHGVXUJLFDOUHYLVLRQ 2YHUDOOSDWLHQWVXQGHUZHQWQHXURPRGXODWRULPSODQWDWLRQDQG610ZDVVWLOO VXFFHVVIXOLQ DWDPHDQODVWIROORZXSRIPRQWKV &, 'XULQJIROORZLQJQHXURPRGXODWRULPSODQWDWLRQ RIWKHSDWLHQWVKDGDQ DGYHUVHHYHQWDQG XQGHUZHQWVXUJHU\EHFDXVHRIDGYHUVHHYHQW Conclusions: 7KHUHLVOLPLWHGHYLGHQFHLQGLFDWLQJWKDW610LVHᚎHFWLYHDQGVDIH IRUWKHWUHDWPHQWRISDWLHQWVZLWKQHXURJHQLF/87'7KHQXPEHU RILQYHVWLJDWHG SDWLHQWVLVORZDQGWKHUHLVDFRPSOHWHODFNRIUDQGRPLVHGFRQWUROOHGWULDOV7KXV ZHOOGHVLJQHGDGHTXDWHO\SRZHUHGVWXGLHVDUHQHHGHGEHIRUHPRUHZLGHVSUHDG XVHRI610IRUQHXURJHQLF/87'FDQEHUHFRPPHQGHG
Eur Urol Suppl 2010;9(2):178
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SACRAL ROOT STIMULATION FOR TREATMENT OF URINARY RETENTION: A NOVEL INTRACANALAR APPROACH USING SELF SIZING NERVE CUFF ELECTRODES. TECHNIQUE DESCRIPTION AND PRELIMINARY RESULTS
%HUWDSHOOH039RWWHUR06TXLQWRQH/&DURQH5&DPSV7 6DOD]]DUL6*LDUGLHOOR* 1 Azienda Ospedaliera CTO/M.Adelaide, Dept. of Neurology, Turin, Italy, 2 Medtronic Bakken Research Centre, Dept. of Research, Maastricht, The Netherlands, 3Medtronic Italia, Dept. of Research, Sesto San Giovanni, Italy Introduction & Objectives: $PDMRUSRLQWLQ6DFUDO1HUYH6WLPXODWLRQ 616 WR WUHDWXULQDU\UHWHQWLRQLVWRWDUJHWQHXUDOVWUXFWXUHVZKHUHGHSRODUL]DWLRQKDVWREH LQGXFHG:HFRQVLGHUVDFUDOURRWVVWLPXODWLRQ 656 LQVLGHWKHVSLQDOFDQDOE\FXᚎ HOHFWURGHVDURXQG6DVDIHUDQGPRUHHᚎHFWLYHDSSURDFK Material & Methods: 7KH LPSODQW VWDUWV ZLWK WHVWLQJ QHHGOHV LQVHUWHG LQ 6 IRUDPLQD DIWHUFXWDQHRXVLQFLVLRQDERYHVDFUDOVSLQRXVSURFHVVHVDQGPXVFXODU GLVVHFWLRQ6VSLQRVDLVUHPRYHGDQGWKHFDQDORSHQHGE\ಯZLQJHGODPLQHFWRP\ರ WRZDUGV HDFK 6 IRUDPHQ 6 URRW LV LGHQWLᚏHG E\ VWLPXODWLRQ DQG D WULSRODU FXᚎ HOHFWURGH 0HGWURQLF0RGHO LVZUDSSHGDURXQGLW7KHHOHFWURGHLVVFUHZHG WRWKHVDFUXPWXQQHOOHGWRWKHᚐDQNDQGFRQQHFWHGWRDEXWWRFNVWLPXODWRU)URP $SULOWR2FWREHU SDWLHQWVXQGHUZHQW6562IWKHIHPDOHSDWLHQWVZLWK XULQDU\UHWHQWLRQKDGIXQFWLRQDOREVWUXFWLRQDQGIDLOHG616KDGFRQFRPLWDQW VHYHUHERZHOFRQVWLSDWLRQGXHWRSHULSKHUDOQHXURSDWK\KDGVHYHUH1HXURJHQLF 2YHUDFWLYH%ODGGHU 12$% LQFRPSOHWHWUDXPDWLFSDUDSOHJLDDQGKDGSUHYLRXV UDGLFDOSHOYLFVXUJHU\2IWKHPDOHSDWLHQWVKDG12$%LQFRPSOHWHWUDXPDWLF SDUDSOHJLDDQGKDGXULQDU\UHWHQWLRQLQ+,9SHULSKHUDOQHXURSDWK\ Results: 1RVXUJLFDOFRPSOLFDWLRQVRFFXUUHG7KHIHPDOHSDWLHQWVZLWKXULQDU\ UHWHQWLRQLQIXQFWLRQDOREVWUXFWLRQVZLWKIDLOHG616KDGLPPHGLDWHFRPSOHWHYRLGLQJ DW PHDQ VWLPXODWLRQ LQWHQVLW\ 9ROWV PHDQ IROORZXS PRQWKV 1RPRUHWKDQWZRVHVVLRQVRISDUDPHWHUVFKDQJLQJZHUHSHUIRUPHGIRUHDFK SDWLHQW1RVSRQWDQHRXVYRLGLQJLQWKHWZRFDVHV RQHPDOHDQGRQHIHPDOH ZLWK GHWUXVRUDFRQWUDFWLOLW\GXHWR+,9QHXURSDWK\DQGSUHYLRXVUDGLFDOSHOYLFVXUJHU\ ,QXULQDU\UHWHQWLRQDVVRFLDWHGZLWKVHYHUHFRQVWLSDWLRQDUHVROXWLRQRIWKHERZHO GLVRUGHUZDVDFKLHYHG,QWKHWZRFDVHVRI12$%LQFRPSOHWHSDUDSOHJLDEODGGHU PD[LPXPFDSDFLW\FKDQJHGIURPsWRsFP+2 Conclusions: ,Q616SURFHGXUHZLWKRSHQRUSHUFXWDQHRXVHOHFWURGHSODFHPHQW TXDGULSRODU OHDG LV QRW FORVHG WR WKH VDFUDO QHUYH EHFDXVH RI VDFUDO SLULIRUPLV PXVFOH DWWDFKPHQW IDW DQG YHVVHOV 7KH VLWH RI VWLPXODWLRQ RXW RI WKH VSLQDO FDQDO DQG WKH ODFN RI WLJKW FRQWDFW ZLWK QHUYRXV VWUXFWXUH PLJKW EH WKH UHDVRQ IRUWKHSHULRGLFDOSDUDPHWHUVFKDQJHVDQGWKHORVVRIHᚑFDF\LQWLPHQDPHO\LQ EODGGHUYRLGLQJG\VIXQFWLRQV(OHFWURGHSODFHPHQWDWWKHUDGLFXODUVLWHDOORZVORZ YROWDJHVWLPXODWLRQDQGUHGXFHVSHULRGLFDOSDUDPHWHUVFKDQJHV7KHJRRGUHVXOWV LQ FRPSOHWH XULQDU\ UHWHQWLRQ GXH WR IXQFWLRQDO REVWUXFWLRQ ZLWK IDLOHG 616 DUH HQFRXUDJLQJ6XUJLFDOLPSODQWRIWULSRODUFXᚎURRWHOHFWURGHVLVDVDIHSURFHGXUHWKDW GRHVQRWUHTXLUHQHXURVXUJLFDOVNLOOVDQGVHHPVWRSURYLGHFRQVLVWHQWVWLPXODWLRQ WRWKHQHUYRXVWLVVXH
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TREATMENT OF NEUROGENIC OVERACTIVE BLADDER (NOAB) IN INCOMPLETE LESIONS BY LOW FREQUENCY CHRONIC PUDENDAL NERVE STIMULATION (CPNS): LONG TERM FOLLOW-UP
6SLQHOOL0=DQROOR/&LWHUL00DODJXWL67DUDQWROD- Niguarda Hospital Milan, Alberto Zanollo Center, Milan, Italy Introduction & Objectives: 7KH HᚎHFWV VDFUDO QHXURPRGXODWLRQ LQ RYHUDFWLYH QHXURJHQLFEODGGHULQ6&,SDWLHQWGXHWRLQFRPSOHWHOHVLRQVKRZVORQJWHUPSRRU UHVXOWV3XGHQGDOQHUYHFKURQLFHOHFWURVWLPXODWLRQXVLQJDTXDGULSRODUOHDGVHHPV WREHSURPLVLQJLQORQJWHUPH[SHULHQFHLQREWDLQLQJDODUJHUFDSDFLW\DQGLQKLELWLRQ RIEODGGHUFRQWUDFWLRQEXWEHVWUHVXOWVDUHREWDLQHGLQLQFRPSOHWHOHVLRQV6WDUWLQJ IURPPD\ZHGHᚏQHGDPHWKRGWRSHUIRUPFKURQLFSXGHQGDOQHUYHVWLPXODWLRQ XVLQJWLQHGOHDGDGRSWHGIRUVDFUDOQHXURPRGXODWLRQ$IWHUDSUHOLPLQDU\H[SHULHQFH LQIHZSDWLHQWVZLWKDSHULQHDODSSURDFKZHDGRSWHGDFRGLᚏHGPHWKRGXVLQJD SRVWHULRUDSSURDFKEDVHGRQERQ\ODQGPDUNVDQGQHXURSK\VLRORJLFDOPRQLWRULQJ Material & Methods: 3XGHQGDOQHUYHVWLPXODWLRQDQGWKHHOHFWURGHSODFHPHQWLV GRQHGXULQJWKHQHXURSK\VLFRORJLFDOPRQLWRULQJXVLQJWKHOHDGDQGWKHLQWURGXFHU NLWDYDLODEOHIRUPLQLPDOO\LQYDVLYHLPSODQWRIVDFUDOQHXURPRGXODWLRQ6LQFH SWVZLWKVDFUDODUHDG\VIXQFWLRQIHPDOH PDOHPHDQDJHs\UV 12$% LGLRSDWKLF 2$% UHWHQWLRQ VSKLQFWHULF GHᚏFLW FRQVWLSDWLRQ 3DLQIXOEODGGHUV\QGURPHZHUHVXEPLWWHGWRWKHSURFHGXUH,Q12$%SDWLHQWV ZHUHUHIUDFWRU\WRDQWLPXVFDULQLFGUXJVDQGEHIRUHGHFLGLQJWRSHUIRUPERWXOLQXP WR[LQ $ %7; LQMHFWLRQ 3XGHQGDO QHUYH VWLPXODWLRQ ZDV FRQVLGHUHG 6WLPXODWLRQ ZDV GHOLYHUHG E\ ELSRODU FRQᚏJXUDWLRQ += PVHF LQWHQVLW\ RI VWLPXODWLRQ DW VXEMHFWLYH WKUHVKROG &OLQLFDO HYDOXDWLRQ ZHUH EDVHG RQ EODGGHU GLDU\ DQG F\VWRPHWU\ Results: 2XWRISWVVXEPLWWHGWRWKHVWVWDJHRILPSODQW SWVUHDFKHGWKHQG VWDJHZHUHH[SODQWHGDQGWUHDWHGE\%7;,QFRQWLQHQFHHSLVRGHVUHGXFHGIURP sDWEDVHOLQHWRs S LQORQJWHUPIROORZXS PHDQPRQWKVUDQJH PHDQFDSDFLW\LQFUHDVHGIURPsWRs S Conclusions: $VLQSUHYLRXVUHSRUWVSXGHQGDOQHUYHVWLPXODWLRQUHSUHVHQWVDQHZ