Surgical techniques of sacral implantation
Section snippets
Implantation of implantable pulse generator in buttock region
One of the earliest modifications of InterStim therapy was to change the location of where the pulse generator is implanted. As originally described, the IPG was to be placed in the anterior abdominal wall. This required the patient to be turned over during the operative case. The S3 lead was first implanted with the patient in a prone position. After the lead was implanted, the patient was turned over to a supine position or a modified flank position to access the abdominal wall. The location
Current surgical approach to sacral neurostimulation
With the development of the minimally invasive percutaneous technique of S3 lead implantation, staged implantation has become widely accepted. The usual approach for patients undergoing sacral neurostimulation is a first-stage procedure of percutaneous implantation of a tined lead into S3 foramen. After sacral neurostimulation through the implanted lead for anywhere between 1 to 4 weeks, if a patient has a significant improvement in bladder symptoms, then he or she undergoes implantation of an
Summary
Refinements in making surgical approaches in sacral neurostimulation less morbid and more efficient has resulted in this approach being a tenable option for those patients afflicted with idiopathic urinary urge incontinence, frequency-urgency syndrome, and nonobstructive urinary retention. Traditionally, these patients were relegated to suffering with their bladder symptoms because of the lack of options. Now, this form of therapy, although not perfect, offers hope to many. Future refinements
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