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Objective: Few studies have addressed the use of sacral nerve stimulation (SNS) in the treatment of patients with multiple pelvic floor dysfunctions (PFD). So, we evaluated the functional outcomes and level of satisfaction with SNS in selected patients with one or multiples PFD. Methods: A prospective database was used to collect information on eligible patients treated for PFD with SNS, and severity of symptoms was assessed with scores and satisfaction rates by visual analogue scale (VAS) at baseline and by the end of follow-up. Results: We recruited 70 patients, 98.6% of whom responded positively during the evaluation period (Global Response Assessment ≥ 50% for at least one type of PFD), resulting in the implantation of a permanent SNS device. Additionally, 49 of the patients (71%) had a single PFD (fecal incontinence [FI] = 38; constipation/obstructed defecation syndrome [C/ODS] = 11), while 20 (29%) had more than one PFD (double incontinence/n = 12; double incontinence + C/ODS/n = 8). All scores improved significantly between baseline (pre-SNS) and the end of follow-up (post-SNS), as did VAS in all groups (single and multiple PFD). The pre-SNS scores were higher in patients with a single PFD, including FI (Cleveland clinic Florida incontinence score [CCF-FI]) and C/ODS (Cleveland clinic constipation score [C-CCF] and the Renzi ODS score). The pre-SNS impact of VAS scores was similar in all groups (single and multiple PFD), but the VAS (post-SNS) was significantly lower (better response) for FI alone compared with multiple PFD. Conclusion: The SNS technique is an effective and safe option for patients with one or more PFD refractory to conservative measures. Response was positive for at least two PFD, based on reduced correspondent scores and satisfaction rate. (AU)
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Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Patient Satisfaction , Pelvic Floor Disorders/therapy , Electric Stimulation Therapy , Surveys and Questionnaires , Treatment OutcomeABSTRACT
Objectives: Vaginal balloon inflation simulates the compressive forces on the pelvic floor during the second phase of natural delivery. The foremost use of this animal model of vaginal distention (VD) is to study the mechanisms underlying urinary incontinence. As damage to the pelvic floor during natural birth is a common cause of fecal incontinence, the present paper aimed to investigate the effect of VD on defecation behavior in adult rats. Methods: Vaginal distention was performed in 8 rats for 2 hours, and in 3 rats for 4 hours, and sham inflation was performed in 4 rats. With the use of a latrine box in the rat home-cage and 24/7 video tracking, the defecation behavior was examined. The time spent in and outside the latrine was monitored for two weeks preoperatively and three weeks postoperatively, and a defecation behavior index (DBI; range: 0 [continent] to 1 [incontinent]) was defined. Pelvic floor tissue was collected postmortem and stained with hematoxylin and eosin. Results: Vaginal balloon inflation for 2 hours resulted in fecal incontinence in 29% of the animals (responders) whereas the DBI scores of non-responders (71%) and control animals did not change in the postoperative phase compared with the baseline score. A 4-hour balloon inflation resulted in fecal incontinence in 1 animal and caused a humane endpoint in 2 animals with markedly more tissue damage in the 4-hour responder compared with the 2-hour responders. Conclusions: Vaginal balloon inflation, with an optimum duration between 2 and 4 hours, can be used as a model to study changes in defecation behavior in rats induced by pelvic floor damage. (AU)
Subject(s)
Animals , Rats , Pelvic Floor/injuries , Defecation , Sprains and Strains , Vagina/injuries , Fecal IncontinenceABSTRACT
Objective:To observe any effect of magnetic stimulation of the primary motor cortex and sacral nerve roots on urinary retention after spinal cord injury.Methods:Forty patients experiencing urine retention after a spinal cord injury were randomly divided into an experimental group and a control group, each of 20. Both groups received conventional treatment and repeated magnetic stimulation of the roots of the sacral nerve. The experimental group also received repeated magnetic stimulation of the bilateral primary motor cortices (M1 region). Bladder capacity and pressure indices, residual urine volume and life quality were evaluated in both groups before and after 8 weeks of treatment.Results:After the treatment, the average maximum bladder pressure, first sensation capacity, residual urine volume and life quality score of both groups had improved significantly, but the improvements in average first sensation capacity, residual urine volume and life quality score of the experimental group were significantly greater than those of the control group. There was, however, no significant difference in the groups′ average maximum bladder pressure after the treatment.Conclusion:Magnetic stimulation of the primary motor cortex and sacral nerve roots can significantly improve the sensory function of the bladder, reduce residual urine volume and improve the life quality of persons experiencing urinary retention after a spinal cord injury.
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Objective:To explore the surgical techniques and clinical effects of minimally invasive adjustable plate (MIAP) together with distraction reduction by minimally invasive anterior pelvic ring internal fixator (INFIX) in the treatment of fresh Denis type ⅡB sacral fracture with sacral nerve injury.Methods:From June 2017 to June 2020, 12 fresh Denis type ⅡB sacral fractures were treated by anterior-posterior distraction reduction and fixation with MIAP and INFIX. There were 8 males and 4 females, with an average age of 30 years (from 16 to 44 years). Preoperatively, imaging found Denis ⅡB fracture of the sacrum and magnetic resonance neurography of the lumbosacral plexus showed injury to the sacral nerve root at the sacral foramen. All patients had symptoms of S 1 nerve root injury on the affected side after injury, with 9 cases of grade M0 and 3 cases of grade M1. The time from injury to operation averaged 11 days (from 5 to 19 days). INFIX combined with MIAP was used to distract and fixate the compressed sacral fracture. The quality of fracture reduction and recovery of sacral nerve function were evaluated postoperatively. Results:According to the criteria proposed by Lindahl et al., the quality of fracture reduction was excellent in 8 cases, good in 2 and fair in 2. The 12 cases were followed up for an average of 20 months (from 12 to 36 months). All sacral fractures got united after an average of 6 weeks (from 5 to 8 months). At one-year follow-up, according to the criteria proposed by the Nerve Injuries Committee of the British Medical Research Council, the postoperative muscle strength recovery was evaluated as complete recovery in 10 cases and as partial recovery in 2 cases.Conclusion:In the treatment of fresh Denis type ⅡB sacral fracture, MIAP combined with INFIX can obtain satisfactory clinical effects because the compressed sacrum can be effectively distracted, the sacral foramen be expanded and the sacral nerve be decompressed indirectly.
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Objective:To explore the fixation with S 2 alar iliac screws (S 2AI) for unstable injury to the pelvic posterior ring. Methods:The clinical data of 18 patients were analyzed retrospectively who had been treated for unstable injury to the posterior pelvic ring by S 2AI screw fixation at Division of Orthopaedics and Traumatology, Department of Orthopaedics, Nanfang Hospital, Southern Medical University and at Department of Orthopaedics and Traumatology, The First Affiliated Hospital to University of South China from September 2017 to December 2020. They were 8 males and 10 females, with an average age of 40 years (from 20 to 64 years). According to Tile classification, there were 3 cases of type B2, 10 cases of type C1 and 5 cases of type C2. Sacral nerve injury was complicated in 3 patients (2 cases of Gibbons grade Ⅱ and one of Gibbons grade Ⅲ). Short-segment S 1-S 2AI fixation was used in 6 cases, contralateral S 1-S 2AI fixation in one case, lumbar-pelvic fixation in 5 cases, and sacroiliac triangle fixation in 6 cases. The accuracy of S 2AI placement was evaluated by CT after operation according to the Shillingford method; the reduction quality of pelvic fractures and complications were documented. Results:All the 18 patients were followed up for 19.8 months (from 12 to 36 months). Bony union was achieved in all fractures. A total of 21 S 2AI were implanted in the 18 patients without intraoperative neurovascular injury. Postoperative CT found penetration into the iliac cortex by S 2AI in 2 cases. According to the Matta criteria, the fracture reduction was excellent in 10 cases, good in 7 and fair in one. Of the 3 patients with preoperative sacral nerve injury, 2 with grade Ⅱ injury recovered to grade Ⅰ and one with grade Ⅲ injury recovered to grade Ⅱ after operation. Superficial infection occurred at the incision site in 2 patients after operation, and complications such as protrusion, rupture or loosening of implants were observed in none of the patients. Conclusion:S 2AI fixation can be flexibly applied to various types of posterior pelvic ring injury and can provide the pelvic ring and the lumbosacral junction with rigid fixation, leading to a low complication rate.
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Objective:To analyze the clinical studies on sacral nerve stimulation based on PubMed database and summarize its research status and clinical characteristics. Methods:Literatures about sacral nerve stimulation were collected from PubMed database before December 31, 2019. HistCite software was used to analyze the published year, published periodicals, published country and research institutions. Pajek software principal path analysis was used to identify the evolution direction of hot topics. The spectrum of diseases, therapeutic outcomes, stimulation methods and stimulation parameters were summarized. Results:A total of 96 articles were included. The number of publications increased significantly since 2000 and reached its peak in 2014 to 2015. The literatures with most influence were published in 2000 to 2001. All the literatures published in 32 journals, the top two were Urology and Diseases of the Colon & Rectum, which published 17 and 22 articles, respectively. The literatures came from 16 countries, and the top three were the United State (17 articles), the Netherlands (13) and the United Kingdom (13). Among the 211 institutes involved, Aarhus University Hospital (Denmark, twelve articles) and St. Marks Hospital (United Kingdom, nine) were the top two. The study involved 16 diseases, mainly about fecal incontinence, urinary incontinence and urination, shifted from urinary system diseases to digestive system diseases. 91.67% of the study corroborated the benefit of sacral nerve stimulation. Implanted stimulation (77 articles) was the most used, and transdermal stimulation (10 articles) was the second. The parameters were depending on the disease and the mode of stimulation. Conclusion:Sacral nerve stimulation can effectively improve the function of pelvic floor, which may be focused for a long time. Non-implantable sacral nerve stimulation would become the new research topic.
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Objective: To investigate the mid-term efficacy of sacral nerve stimulation (SNS) for chronic constipation. Methods: A descriptive case series study was conducted. Patients with chronic constipation were treated in Xijing Hospital of Digestive Disease from February 2013 to December 2018 were retrospectively enrolled. The types of constipation were confirmed based on colon slow transit test, anorectal manometry and defecography in Xi'an Mayinglong Coloproctological Hospital. This study has been registered in China clinical trial registry (Registration No.: ChiCTR-ROC-16008945). Case inclusion criteria: (1) constipation was diagnosed according to Rome III criteria; (2) traditional treatment, including education, diet adjustment, laxative, biofeedback treatment, failed for at least 1 year; (3) there were no constipation-related organic diseases. After excluding neurogenic diseases, including spinal cord injury and multiple sclerosis, 21 patients were included in this study. There were 10 males and 11 females, with an average age of 50.9 (14-76) years. After the relevant examination and evaluation of patients, they underwent percutaneous nerve evaluation (PNE). If patient experienced a good response to PNE after 2 or 3 weeks (≥50%), permanent SNS implantation was performed. The improvement of clinical symptoms and quality of life between the baseline, PNE, and latest follow-up time points were compared. Improvement of clinical symptoms, including autonomic stool frequency per week, autonomic stool days per week, defecation time, visual analogue scale (VAS, lower score indicates more serious symptoms) score and Cleveland clinic constipation score (CCCS, higher score indacates more serious symptoms) criteria. The change of quality of life was scored by SF-36 questionnaires (the higher score indicates better quality of life). Results: Of 21 patients, 18 (85.7%) experienced significant improvement in symptoms with PNE, and 2 patients discontinued treatment due to their dissatisfaction. Sixteen patients (76.2%) received permanent SNS implantation, two of whom underwent bilateral PNE implantation. These patients were followed-up for mean 56 (34-72) months. The treatment was continuously effective in 13 patients (61.9%), including 3 of ODS, 1 of STC and 9 of mixed constipation. Compared with baseline, the score of constipation patients receiving permanent SNS implantation at latest follow-up was shown. The median autonomic stool frequency per week increased from 1.0 (0-7) to 7.5 (0-10) (P<0.001), the median autonomic stool days per week increased from 1.0 (0-7) d to 4.5 (0-7) d (P<0.001), the median defecation time decreased from 19.0 (8-40) minutes to 4.0 (3-31) minutes (P<0.001), the median CCCS decreased from 20.0 (13-30) to 9.0 (6-30) (P<0.001), and the median VAS score increased from 9.0 (7-40) to 80.0 (15-90) (P<0.001). The values of the 8 parts of the SF-36 questionnaire increased (all P<0.05). Conclusion: SNS implantation is safe and has obvious effects on severe constipation with stable mid-term efficacy.
Subject(s)
Humans , Middle Aged , China , Constipation/therapy , Quality of Life , Retrospective StudiesABSTRACT
Objective:To investigate the clinical efficacy of sacral nerve root magnetic stimulation combined with Solifenacin in women with refractory overactive bladder (OAB). Methods:From January to December, 2017, 120 women with refractory OAB were randomly divided into sacral nerve root magnetic stimulation group (group A, n = 40), Solifenacin group (group B, n = 40), and combined treatment group (group C, n = 40). Before and after treatment, they were assessed with the urine diary (number of daily urination, number of nightly urination, single urine output, number of urgent urination), urodynamic index (initial urinary bladder capacity, maximum bladder capacity) and Overactive Bladder Symptom Score (OABSS). Results:Two patients from group A, one from group B and one from group C were dropped out. The number of daily urination, the number of nightly urination, the single urine output, the number of urgent urination, the initial urinary bladder capacity and maximum bladder capacity, and OABSS were better in group C than in groups A and B (P < 0.05). Conclusion:Sacral nerve root magnetic stimulation combined with Solifenacin is effective and better than anyone alone on women with refractory OAB.
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The technical review for clinical trials of implantable sacral nerve stimulation system needs to focus on the basic principles of trials, clinical institutition and design elements of clinical trial protocols.
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Objective To observed the clinical effect of long-term sacral nerve stimulation on anal rectal pain after lumbar surgery.Methods A total of 18 cases with functional anorectal pain (FARP) after lumbar surgery in our hospital from April 2015 to March 2018were selected, of whom 3 cases refuse to accept the treatment, the other 15 cases received sacral nerve electrical stimulation.The Pittsburgh Sleep Quality Index (PSQI) and simplified MPQ pain questionnaire were used to evaluate the clinical effect in preoperative and postoperative1 week, 1 month, 3 months, 6 months, 9 months and 1 year respectively.Results Fifteen cases of permanent sacral nerve stimulation before and after , The MPQ scale and PSQI of 15 patients with implantation of permanent sacral nerve stimulation in postoperative 1 week were better than those before implantation , the differences were significant( P＜ 0. 05) . In the MPQ scale , the PPI and PRI at 6 months after operation was better than those before implantation , the difference was statistically significant ( P ＜ O. 01 ) ; PSQI and V AS score after 2 months were better than those before implantation , the difference were statistically significant( P ＜ 0.01) , meanwhile in 1-year of follow-up , the PSQI and VAS score continued to decline , but the change was not obvious. Conclusion Long-term sacral nerve electrical stimulation in the treatment of lumbar anorectal pain has a good clinical effect , which can improve patients ' quality of life.
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BACKGROUND/AIMS: The aim of this study was to evaluate the sustainability of sacral neuromodulation (SNM) success in patients with fecal incontinence (FI) and/or constipation. METHODS: This is a retrospective analysis of a prospective database of patients who received SNM therapy for FI and/or constipation between 2006 and 2015. Success rates, complications and reintervention rates were assessed after up to 10 years of follow-up. RESULTS: Electrodes for test stimulation were implanted in 101 patients, of whom 79 (78.2%) received permanent stimulation. The mean follow-up was 4.4 ± 3.0 years. At the end of follow-up, 57 patients (72.2%) were still receiving SNM. The 5-year success rate for FI and isolated constipation was 88.2% (95% confidence interval [CI], 80.1–97.0%) and 31.2% (95% CI, 10.2–95.5%), respectively (P 50% in 76.1% of patients (95% CI, 67.6–86.2%) after 5 years. A lead position at S3 was associated with an improved outcome (P = 0.04). Battery exchange was necessary in 23 patients (29.1%), with a median battery life of 6.2 years. Reinterventions due to complications were necessary in 24 patients (30.4%). For these patients, the 5-year success rate was 89.0% (95% CI, 75.3–100.0%) compared to 78.4% (95% CI, 67.2–91.4%) for patients without reintervention. CONCLUSIONS: SNM offers an effective sustainable treatment for FI. For constipation, lasting success of SNM is limited and is thus not recommended. Reinterventions are necessary but do not impede treatment success.
Subject(s)
Humans , Constipation , Electric Stimulation , Electrodes , Fecal Incontinence , Follow-Up Studies , Prospective Studies , Retrospective StudiesABSTRACT
This paper delineate the definition,etiology and treatment of fecal incontinence,Initial management of fecal incontinence consists of supportive care and medical therapy.If patients fail to re-spond to initial management,such patients should undergo additional evaluation(such as anorectal manom-etry,endorectal ultrasound and magnetic resonance imaging)to detect functional and structural abnormali-ties causing fecal incontinence and to guide subsequent management.For patients who fail to respond to initial management,options include biofeedback,injectable anal bulking agent,sacral nerve stimulation, and anal sphincteroplasty.Dynamic graciloplasty and artificial anal sphincter devices are associated with significant morbidity and should therefore only be used to treat refractory fecal incontinence.Fecal diver-sion with a colostomy should be reserved for patients with intractable symptoms who are not candidates for any other therapy,or in whom other treatments have failed.
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Objective To evaluate the efficacy of triamcinolone acetonide injection by ganglion impar block in treating sacral nerve dysfunction syndrome.Methods Fifty-four cases of sacral nerve disorder syndrome,mainly presented with anal pendant expansion,were admitted between October 2014 to October 2016.The clinical efficacy assessed by visual analogue scale(VAS)was recorded and analyzed.Results For all patients,the symptoms were relieved in 15 minutes after ganglion impair block,and the VAS was significantly reduced after treatment.The excellent rate was 81.5％ and the total efficiency was 100.0％ in one week after surgery.Meanwhile,the excellent rate and the total efficiency were 90.7％ and 100.0％ in one month,94.4％ and 100.0％ in 3 months,83.3％ and 100.0 ％ in 6 months,respectively.Conclusions Triamcinolone acetonide injection by ganglion impar block is effective for sacral nerve dysfunction mainly presented with anal pendant expansion.
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Objective:To evaluate the effect of sacral nerve stimulation (SNS) for STC by receptor tyrosine kinase c-kit.Methods:Wistar rats were fed with diphenoxylate to make slow transit constipation(STC) rat model.Sacral nerve stimulation(SNS) for the SNS Rat Group.The studied animals were allocated into three experimental groups:STC Rat Group;SNS Rat Group;Normal Rat Group;Every group included 10 rats.The c-kit of ICC in the subserosal layer of rats were analyzed by immunohistochemistry,western blot and RT-PCR.Results:The morphological characteristics of STC Rat Group were not comparable to those of the multipolar c-Kit positive ICC seen in the subserosa of colon of normal rat.In the colon of rat,c-kit protein and c-kit gene in SNS rat group and Normal rat group was significantly higher than STC rat group detecting by western blot.Statistical differences between STC Group and SNS Rat Group were found (P＜0.05);statistical differences between STC Group and Normal Rat Group were also found (P＜0.05).There was not statistical differences between SNS rat group and Normal Rat Group.Conclusion:SNS has effective treatment for the STC rat.
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The majority of patients with neuropathic incontinence and other pelvic floor conditions associated with straining at stool have damage to the pudendal nerves distal to the ischial spine. Sacral nerve stimulation appears to be a promising innovation and has been widely adopted and currently considered the standard of care for adults with moderate to severe fecal incontinence and following failed sphincter repair. From a decision-to-treat perspective, the short-term efficacy is good (70%–80%), but the long-term efficacy of sacral nerve stimulation is around 50%. Newer electrophysiological tests and improved anal endosonography would more effectively guide clinical decision making.
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Adult , Humans , Biofeedback, Psychology , Clinical Decision-Making , Electrophysiology , Endosonography , Fecal Incontinence , Pelvic Floor , Pudendal Nerve , Spine , Standard of CareABSTRACT
PURPOSE: We investigated the effects of different stimulation frequencies on the inhibition of bladder overactivity by sacral neuromodulation (SNM) in pigs. METHODS: Implant-driven stimulators were used to stimulate the S3 spinal nerve in 13 pigs. Cystometry was performed by infusing normal saline (NS) or acetic acid (AA). SNM (pulse width, 210 µsec) at frequencies ranging from 5 to 50 Hz was conducted at the intensity threshold at which observable perianal and/or tail movement was induced. Multiple cystometrograms were performed to determine the effects of different frequencies on the micturition reflex. RESULTS: AA-induced bladder overactivity significantly reduced the bladder capacity (BC) to 34.4%±4.7% of the NS control level (354.4±35.9 mL) (P0.05), but SNM at 15, 30, and 50 Hz significantly increased the BC to 54.5%±7.1%, 55.2%±6.5%, and 57.2%±6.1% of the NS control level (P0.05). CONCLUSIONS: This study demonstrated that 15 Hz was an appropriate frequency for SNM and that frequencies higher than 15 Hz did not lead to better surgical outcomes.
Subject(s)
Acetic Acid , Reflex , Spinal Nerves , Swine , Tail , Urinary Bladder , Urinary Bladder, Overactive , UrinationABSTRACT
PURPOSE: InterStim device is an U.S. Food and Drug Administration approved minimal invasive therapy for sacral neuromodulation for lower urinary tract dysfunction. Before InterStim implantation, a trial with the appropriate screening tests is required to determine patient therapy eligibility. There are two different techniques for patient screening: percutaneous nerve evaluation (PNE) test and staged test. Few studies have reported success and failure rates for each technique. However, test sensitivity and predictive values of either test have not been studied. The aim of our study was to determine the sensitivity and specificity of each test and to establish a decision algorithm for the most appropriate testing method to be used as a screening test. METHODS: This cross-sectional study was conducted from August 2009 to February 2012 and included patients with lower urinary tract dysfunction who participated in the stimulation test trial. Patients underwent PNE as the first stimulation test, while those who encountered technical difficulty during PNE or electrode migration underwent staged testing. RESULTS: A total of 213 patients, including 172 female and 41 male subjects, underwent PNE. The patients’ diagnoses included refractory overactive bladder (47.9%), nonobstructive urinary retention (29.6%), and frequency urgency syndrome (22.1%). A total of 202 patients were screened with PNE and 10 patients with staged testing. Overall sensitivity of PNE was 87.3%, and it was 90% for staged test. PNE specificity was 98.5% as compared to 92.9% for staged test. Positive and negative predictive values for PNE were 99% and 82.1% and for staged test were 90% and 92.9%, respectively. CONCLUSIONS: PNE test has high specificity and positive predictive value. We recommend PNE, a simple office-based, less expensive procedure as the first option for screening.
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Female , Humans , Male , Cross-Sectional Studies , Diagnosis , Electrodes , Mass Screening , Methods , Sensitivity and Specificity , United States Food and Drug Administration , Urinary Bladder, Overactive , Urinary Retention , Urinary TractABSTRACT
Objective To investigate the clinical and pathological features of sacral nerve root lesions and the diagnosis and treatment for these clinical entities.Methods The clinical data of the patients with urine retention or refractory lower urinary tract symptoms (LUTS) caused by sacral nerve root lesions were retrospectively analyzed.Totally 27 patients were included in this study,including 4 cases of acute retention,6 chronic retention and 17 refractory LUTS.All patients had urodynamic disorders and sacral nerve root space-occupying lesions demonstrated by magnetic resonance imaging.All the patients received surgical treatment and were followed up one year or more.Results The pathological findings included simple cyst in 3 cases,ganglioneuroma in 5,cyst wall inflammation in 15,cyst wall hyaline degeneration in 15,and neurodegeneration in 15.Postoperatively,9 of the 10 patients with retention could voluntarily void and 1 remained suprapubic catheter drainage.All 17 patients with refractory LUTS improved significantly in terms of international prostate symptom score,visual analogue scale pain score,quality of life,maximal urinary flow rate and post void residual (P＜0.01).Conclusions Sacral nerve root lesions can be the causes of urinary retention or refractory LUTS.Surgical treatment can improve patient's voiding function and quality of life.
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@#Objective To observe the effect of electroacupuncture on nerve root of sacral spinal nerve 3 for detrusor hyperreflexia after spinal cord injury. Methods 32 spinal cord injury patients with detrusor hyperreflexia accepted electroacupuncture at sacral 3 nerve root.Their voiding diary, urodynamics and quality of life were observed before and 8 weeks after treatment. Results The frequency of urination,urine leakage, and filling the final detrusor pressure decreased (P<0.05), and the urine output, maximum bladder capacity, bladder compliance,score of quality of life increased (P<0.05) after treatment. There was no significant change in residual urine volume after treatment (P>0.05). Conclusion Electroacupuncture on nerve root of sacral spinal nerve 3 is effective on detrusor hyperreflexia after spinal cord injury.
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Objective To investigate the diagnosis and treatment of sacral nerve dysfunction syndrome.Methods Accepted 44 cases of sacral nerve disorder syndrome from Oct.2010 to Oct.2012 in the Department General Surgery of Xiangyang Central Hospital,the diagnosis and treatment of sacral nerve dysfunction syndrome were retrospectively analyzed.Results All 44 patients in this group were founded been with lumbar protrusion of the intervertebral disc,the incidence of waist 4-5 or/and sacral 1 intervertebral disc herniation was 100％.Twentyone patients were complicated with vertebral degenerative changes,6 cases with spinal arachnoid cyst.metastatic cancer without treatment in 1 case was exception,13 cases were boarded during sleeping,12 cases were given dehydration treatment with mannitol,15 cases were given therapy of sacral canal nerve block,3 cases were treated by operation.All of these treatment were proved effective.Conclusion Some certain curative effect was obtained through the local physical therapy,systemic dehydration treatment,local nerve block treatment and opertion treatment.