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At least 1,189 records · Page 66Linked to original sources
PubMed1989

Sacral epidural electrodes for voiding in the chronic spinal dog.

Recent reports have shown that electrical stimulation of the bladder wall or sacral nerves is effective for bladder management in the spinal cord injured (SCI) patient. However, less invasive methods are needed for electrode implantation. A modified percutaneous procedure for implanting needle electrodes in the sacral canal was evaluated. Stimulation with these electrodes were effective for inducing voiding with little residual volume after the recovery of bladder reflexes, 3 weeks after experimental spinal cord injury in the dog. An optimum electrode arrangement involved a single midline monopolar electrode located between sacral foramina L7 and S1. However, at low stimulating current, lateral electrodes adjacent to sacral nerves were more effective than midline electrodes for inducing voiding. Stimulation parameters that were effective for daily voiding were 10 pps, 1.5-5 mA, 0.3 ms pulse duration, and 2- to 3-second stimulation periods.

Animals↗
PubMed1975

Studies on the nature of the vasodilator fibers running in the lumbar sympathetic chain of the dog.

These experiments were performed to further elucidate the nature of the vasodilator fibers running in the sympathetic chain in the dog. The electrostimulation of the lumbar sympathetic trunk caused vasoconstriction in the perfused hind limb which inverted to vasodilatation after guanethidine was administered. This vasodilator response is mediated by cholinergic fibers since it was completely abolished by atropine. The observation, furthermore, that hexamethonium completely nullified both vasodilator and vasoconstrictor responses to the electrostimulation of the sympathetic chain indicates that both vasoconstrictor and vasodilator fibers, which are activated during the stimulation of the sympathetic chain, are preganglionic in nature.

Animals↗
PubMedDate not supplied

Dermofluorography as a possibility for therapeutic control following sympathectomy.

The assessment of completeness of a sympathectomy can be objectively recorded and documented by dermofluorography. This method enables measurement of increased skin perfusion which leads to an earlier appearance time and steeper initial rise in fluorescence of intravenously administered sodium fluorescein. The most significant parameters are the quotients of the average appearance time and the initial rise in fluorescence of the untreated versus treated leg. Following a successful lumbar sympathectomy, these parameters were outside 3 standard deviations of the values obtained from healthy test persons.

Adult↗
PubMed1975

Urodynamic analysis of differential sacral nerve blocks and sacral neurectomy.

Urodynamic analysis in 17 patients after long-acting anaesthetic root blocks of S2-S4 has shown that it is possible to increase bladder capacity and reduce uninhibited contractions without significant adverse effects on sphincter function. Satisfactory voiding dynamics are observed after blocks. This has provided a physiological rationale for selective sacral neurectomy in eight patients. Initial improvement after operation has been noted in seven cases.

Anesthesia, Conduction↗
PubMed1975

Diagnosis of neurologic disorders of micturition without evidence of the pathological process by measuring conduction velocity of sacral roots.

In cases of neurogenic bladder disturbances-especially if the pathological process cannot be clinically approved-useful information could be obtained by measuring conduction velocity between sacral roots and striated pelvic floor muscles. Measurements have been performed to determine normal conduction time. Technique and results are presented.

Anal Canal↗
PubMed1979

Feasibility of controlled micturition through electric stimulation.

Historically, man has been aware of bioelectric phenomena for some 4,000 years. Yet it has only been during the last 20 years that technology has advanced to the stage where controlled bladder emptying has become feasible. A great deal of interest followed the introduction of transistor and bladder stimulation via the principle of radio frequency induction. Spinal cord, sacral, and pelvic nerve and direct bladder stimulation have all been attempted. Only direct bladder stimulation in lower motor neuron situations has shown any promise. The many difficulties associated with bladder stimulation include simultaneous sphincter contraction, pain, electrode and insulation difficulties, and fibroplasia due to movement of electrodes placed in pliable tissues. In addition, the role of the prostate, increased urethral length, and erection responses in the male have received little investigation. These problems are outlined and experimental observations of attempts to achieve controlled micturition in canines areresented. These studies were carried out over a 3-year period, and emphasize responses to stimulation of the spinal cord and sacral roots. It was concluded that the most efficient manner by which to effect simulated micturition is via stimulation of the ventral sacral root dominant for bladder responsiveness, and combine this with selective division of somatic fibers of only the root being stimulated.

Animals↗
PubMed1993

Neuromodulation of sacral nerves for incontinence and voiding dysfunctions. Clinical results and complications.

Neuromodulation of sacral nerves is a new form of treatment for patients with refractory voiding dysfunctions such as incontinence, retention and chronic pelvic pain. Electrical stimulation of S3 activates the pelvic floor and modulates innervation of the bladder, sphincter and pelvic floor, restoring the balance and coordination in sacral reflexes. 19 of 23 patients with an implanted neuroprosthesis for neuromodulation have a more than 50% improvement in their main symptoms after a median follow-up of 12 months. In urge-incontinent patients the number of leakings decreased from 7.4 to 1.5/day, and the functional capacity increased from 135 to 227 ml.

Abdominal Pain↗
PubMed1997

Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. Part I: Clinical and urodynamic analysis. Dutch Study Group on Sacral Anterior Root Stimulation.

OBJECTIVES: To present the clinical and urodynamic results of the treatment of neurogenic bladder dysfunction in spinal cord injury by sacral rhizotomies and electrical bladder stimulation with the Finetech-Brindley stimulator during a 3-year inclusion and study period. METHODS: 226 patients with spinal cord lesion and urological problems due to hyperreflexia of the bladder were screened for sacral rhizotomies and electrical bladder stimulation. In 52 patients complete posterior sacral root rhizotomies were performed and a Finetech-Brindley sacral anterior root stimulator implanted. All patients were screened and followed with a standard protocol. RESULTS: Complete continence during daytime was achieved in 73% of patients with 6-month follow-up and in 86% at night. Significant increase in bladder capacity and bladder compliance was achieved in all patients. Residual urine was reduced significantly, resulting in a decrease of the incidence of urinary tract infections. CONCLUSIONS: The treatment of neurogenic bladder dysfunction in spinal cord injury by anterior sacral root stimulation with the Finetech-Brindley stimulator in combination with sacral posterior root rhizotomy produces excellent results with limited morbidity.

Adolescent↗
PubMed1997

Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. 2. Cost-effectiveness and quality of life analysis. Dutch Study Group on Sacral Anterior Root Stimulation.

OBJECTIVES: To present a cost-effectiveness analysis of sacral rhizotomies and electrical bladder stimulation compared with conventional care of neurogenic bladder dysfunction in patients with spinal cord injury. METHODS: During a 3-year inclusion period, data on costs and quality of life before the intervention were collected to describe conventional care. Data on the pre-implantation period, the implantation and a follow-up period of 2 years were collected following a strict protocol simultaneous with medical and urodynamic data and were used to calculate the costs and effects on quality of life of the implantation of the stimulator. RESULTS: Between June 1991 and June 1994, 52 patients with complete cervical or thoracic spinal cord lesions underwent sacral posterior rhizotomies and implantation of a Finetech-Brindley sacral anterior root stimulator. Although the initial costs of sacral anterior root stimulation are high, they are earned back in this series in about 8 years after the implantation. General indicators of the quality of life show no significant changes after the implantation. Factors related to psychological well-being and the patients' satisfaction with the emptying of the bladder increased significantly whereas the experienced problems of micturition and incontinence all decreased significantly. CONCLUSION: Sacral rhizotomies and electrical bladder stimulation make a cost-effective method of treatment of lower urinary tract dysfunction in patients with spinal cord injury. Considerable savings on health care costs are possible in the long run with simultaneous positive effects on aspects of health status.

Adolescent↗
PubMedDate not supplied

Hypereosinophilic syndrome accompanying gangrene of the toes with peripheral arterial occlusion--a case report.

The authors herein report the case of a teenage boy who presented with peripheral arterial occlusion of both upper and lower extremities associated with hypereosinophilia. During a 10-year follow-up, corticosteroid therapy was continued for the treatment of hypereosinophilia. The patient underwent bilateral lumbar sympathectomies because of severe ischemia of the bilateral lower extremities with gangrene of the toes. Based on the progress of his disease over the past 10 years, he was suspected to have idiopathic hypereosinophilic syndrome (HES) accompanied by peripheral arterial obstruction. Idiopathic HES is a disease characterized by unexpected hypereosinophilia, which may lead to organ damage. This is a very rare case of peripheral arterial occlusion associated with idiopathic HIS.

Amputation, Surgical↗
PubMed2001

Single-stage lumbar sympathectomy and omentopexy: a new surgical approach towards patients with Buerger's disease.

Single-stage lumbar sympathectomyand omentopexy were performed in six patients with Buerger's disease at the Department of Surgery, Jawahar Lal Nehru Medical College and Hospital, Ajmer, India, between January 1994 and December 1996. All were male smokers and had limb coldness, intermittent claudication and rest pain. Four had limb discoloration and three had ulcers of toes unresponsive to medical treatment. Postoperatively there was relief of symptoms in all, with improvement of tissue oxygen saturation and increase in claudication distance. We conclude that single-stage lumbar sympathectomy and omentopexy is an effective new surgical approach towards patients with Buerger's disease.

Adult↗