Transcutaneous pudendal nerve stimulation for refractory urinary incontinence: A viable option?

2021 ◽  
Author(s):  
Stefano Terzoni ◽  
Paolo Ferrara ◽  
Cristina Mora ◽  
Sara Alessandrini ◽  
Arianna Federica ◽  
...  
Keyword(s):  
Urinary Incontinence ◽  
Nerve Stimulation ◽  
Pudendal Nerve ◽  
Viable Option ◽  
Pudendal Nerve Stimulation

scholarly journals Bilateral electrical pudendal nerve stimulation as additional therapy for lower urinary tract dysfunction when stage II sacral neuromodulator fails: a case report

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shan Chen ◽  
Siyou Wang ◽  
Yunqiu Gao ◽  
Xiaolian Lu ◽  
Jiasheng Yan ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Nerve Stimulation ◽  
Lower Urinary Tract ◽  
Pudendal Nerve ◽  
Sacral Neuromodulation ◽  
Lower Urinary Tract Dysfunction ◽  
Urinary Frequency ◽  
Pudendal Nerve Stimulation ◽  
Additional Therapy ◽  
Lower Urinary

Abstract Background Sacral neuromodulation (SNM) has become an effective therapy for patients with lower urinary tract dysfunction (LUTD) who do not respond to conservative treatment. However, an effective treatment strategy for patients who fail SNM has not yet been identified. An option for LUTD is needed when the clinical response to the SNM diminishes. Case presentation A 51-year-old Chinese man presented to an outpatient clinic complaining of difficulty in urination for > 3 years. The patient also complained of urinary frequency and urgency, accompanied by perineal discomfort. He was diagnosed with LUTD based on his symptoms and previous examinations. The patient underwent sacral neuromodulation with a permanent implantable pulse generator (IPG) (provided free of charge by Chengnuo Medical Technology Co., Ltd.; General Stim, Hangzhou, China) in the left buttock, as he participated in the company’s clinical trial to test the long-term effects of IPG. He reported loss of efficacy of the device 3 months after the implantation. We performed bilateral electrical pudendal nerve stimulation (EPNS) therapy for him. After 2 weeks of treatment, he began to report smooth voiding within 2 h after EPNS, and a moderate improvement in urinary frequency, urgency, and perineal discomfort. After 4 weeks of EPNS, the patient reported > 50% improvement in his urination, evaluated with the short form of the International Consultation on Incontinence Questionnaire for Male Lower Urinary Tract Symptoms. He reported smooth voiding, moderate improvements in urinary frequency and urgency, and the disappearance of the perineal discomfort. He also reported improved sleep and erections. The patient was discharged after 8 weeks of EPNS treatment. Conclusion EPNS could be an option as an additional therapy for patients with LUTD who have failed SNM.

scholarly journals Pudendal Nerve Stimulation and Block by a Wireless-Controlled Implantable Stimulator in Cats

2013 ◽  
Vol 17 (5) ◽  
pp. 490-496 ◽  
Author(s):  
Guangning Yang ◽  
Jicheng Wang ◽  
Bing Shen ◽  
James R. Roppolo ◽  
William C. de Groat ◽  
...  
Keyword(s):  
Nerve Stimulation ◽  
Pudendal Nerve ◽  
Pudendal Nerve Stimulation ◽  
Implantable Stimulator

scholarly journals Benzodiazepines Suppress Neuromodulatory Effects of Pudendal Nerve Stimulation on Rat Bladder Nociception

2020 ◽  
Vol 130 (4) ◽  
pp. 1077-1084 ◽  
Author(s):  
Timothy J. Ness ◽  
Jamie McNaught ◽  
Buffie Clodfelder-Miller ◽  
Dwight E. Nelson ◽  
Xin Su
Keyword(s):  
Nerve Stimulation ◽  
Pudendal Nerve ◽  
Pudendal Nerve Stimulation ◽  
Rat Bladder

Neuromodulatory effects of pudendal nerve stimulation on bladder hypersensitivity are present in opioid-pretreated rats

2019 ◽  
Vol 44 (11) ◽  
pp. 1015-1020 ◽  
Author(s):  
Timothy John Ness ◽  
Jamie McNaught ◽  
Buffie Clodfelder-Miller ◽  
Dwight E Nelson ◽  
Xin Su
Keyword(s):  
Nerve Stimulation ◽  
Pudendal Nerve ◽  
Opioid Therapy ◽  
Abdominal Muscle ◽  
Significant Inhibition ◽  
Regulatory Approval ◽  
Bladder Pain ◽  
Pudendal Nerve Stimulation ◽  
Rat Pups ◽  
Dependent Inhibition

Background and objectivesBilateral electrical pudendal nerve stimulation (bPNS) reduces bladder hypersensitivity in rat models and anecdotally reduces pain in humans with pelvic pain of urologic origin. Concomitant opioids are known to alter responses to neuromodulation in some systems. So prior to the development of a clinical trial for purposes of regulatory approval, the preclinical interaction between opioids and stimulation effectiveness was examined.MethodsBladder hypersensitivity was produced by neonatal bladder inflammation in rat pups coupled with a second inflammatory insult as an adult. Morphine was administered acutely (1–4 mg/kg intraperitoneal) or chronically (5 mg/kg subcutaneously daily for 2 weeks prior to the terminal experiment). bPNS consisted of bilateral biphasic electrical stimulation of the mixed motor/sensory component of the pudendal nerves. Visceromotor responses (VMR; abdominal muscle contractile responses to urinary bladder distension (UBD)) were used as nociceptive endpoints.ResultsMorphine produced a dose-dependent inhibition of VMRs to UBD that was naloxone reversible. bPNS resulted in statistically significant inhibition of VMRs to UBD in hypersensitive rats that had received acute or chronic subcutaneous morphine injections.ConclusionsThis study suggests that inhibitory effects of bPNS can still be evoked in subjects who are receiving opioid therapy, thus giving guidance to potential clinical trials seeking regulatory approval for the treatment of chronic bladder pain.

Spinal and pudendal nerve modulation of human corticoanal motor pathways

1998 ◽  
Vol 274 (2) ◽  
pp. G419-G423 ◽  
Author(s):  
Shaheen Hamdy ◽  
Paul Enck ◽  
Qasim Aziz ◽  
John C. Rothwell ◽  
Samet Uengoergil ◽  
...  
Keyword(s):  
Anal Sphincter ◽  
Nerve Stimulation ◽  
External Anal Sphincter ◽  
Neural Control ◽  
Pudendal Nerve ◽  
Cortical Stimulation ◽  
Evoked Responses ◽  
Pudendal Nerve Stimulation ◽  
Sphincter Function ◽  
Sensorimotor Interactions

We investigated the effects of lumbosacral and pudendal nerve stimulation on the corticofugal pathways to the human external anal sphincter. In 11 healthy subjects, anal sphincter electromyographic responses, evoked to transcranial magnetic stimulation of the motor cortex, were recorded 5–500 ms after lumbosacral root or pudendal nerve stimulation. Lumbosacral and pudendal nerve stimulation alone evoked responses with amplitudes of 293 ± 73 and 401 ± 153 μV and latencies of 3.2 ± 0.2 and 2.2 ± 0.2 ms, respectively. Cortical stimulation also evoked responses with amplitudes of 351 ± 104 μV and latencies of 20.9 ± 1.1 ms. When lumbosacral or pudendal nerve stimulation preceded cortical stimulation, the cortically evoked responses were facilitated ( P < 0.01), with the effect appearing greatest at 5–20 ms after both lumbosacral and pudendal excitation and at 50–100 ms after lumbosacral excitation alone. Our results demonstrate that cortical pathways to the external anal sphincter are facilitated by prior lumbosacral and pudendal nerve stimulation, indicating that sensorimotor interactions are important in the central neural control of sphincter function.

Bladder inhibition or voiding induced by pudendal nerve stimulation in chronic spinal cord injured cats

2007 ◽  
Vol 26 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Changfeng Tai ◽  
Jicheng Wang ◽  
Xianchun Wang ◽  
William C. de Groat ◽  
James R. Roppolo
Keyword(s):  
Spinal Cord ◽  
Nerve Stimulation ◽  
Pudendal Nerve ◽  
Pudendal Nerve Stimulation ◽  
Spinal Cord Injured ◽  
Bladder Inhibition
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