Article

OBJECTIVES: To assess the concomitant clinical improvement in incomplete spinal
cord injury patients (SCIPs) suffering from neurogenic bowel symptoms (NBSs),
neurogenic lower urinary tract symptoms (NLUTSs) and neurogenic erectile
dysfunction (NED) using sacral neuromodulation (SNM) for NBSs and NLUTSs.
METHODS: Seventy-five SCIPs were selected. Before and during the follow-ups
post-SNM, NLUTSs and NBSs were detected mainly through specific diaries. Erectile
function was assessed using the International Index of Erectile Function composed
of 5 questions (IIEF5). Quality of life (QoL) was measured with the Short Form 36
Health Survey questionnaire (SF-36). During the first stage, in which a permanent
electrode was inserted percutaneously into the third sacral foramina and
stimulated using an external generator, patients with NBSs or NLUTSs were
required to improve their symptoms by at least 50% compared with baseline before
proceeding to the second stage in which the generator was placed in the patient's
buttock. NED patients needed to increase their IIEF5 score by at least 25%
compared with baseline (evaluated initially 3 months after the second stage) in
order to continue follow-up. RESULTS: Fourteen out of 37 subjects who manifested
two functional pelvic dysfunctions at baseline maintained notable clinical
improvement in two pelvic functions (median follow-up >3 years). Six had
non-obstructive retention (NOR) and NED, six double incontinence, and two
constipation with NOR. In the general and mental health domains of the SF-36, all
patients improved their scores by at least 20% compared with baseline.
CONCLUSIONS: SNM may be beneficial to selected incomplete SCIP with concomitant
pelvic functional disturbances.

Langue : ANGLAIS