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Application of ultrasound during electrode implantation for sacral neuromodulation in patients with neurogenic bladder secondary to spinal cord disease: a retrospective study.

Authors
  • Chen, Qi1
  • Chen, Guoqing2
  • He, Xijing3
  • Chong, Tie1
  • Zhou, Jinsong4
  • Zhang, Jianshui4
  • Han, Hua4
  • Nan, Ning1
  • 1 Department of Urology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China. , (China)
  • 2 Department of Urology, China Rehabilitation Research Center, Beijing, 100068, China. [email protected] , (China)
  • 3 Department of Orthopedics, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, Shaanxi, China. [email protected] , (China)
  • 4 Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, 710061, Shaanxi, China. , (China)
Type
Published Article
Journal
International Urology and Nephrology
Publisher
Springer-Verlag
Publication Date
Jul 01, 2021
Volume
53
Issue
7
Pages
1325–1330
Identifiers
DOI: 10.1007/s11255-021-02824-8
PMID: 33743121
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

To compare the use of intraoperative ultrasound with X-ray fluoroscopy during sacral neuromodulation lead electrode placement in patients with neurogenic bladder secondary to spinal cord disease. We reviewed the medical records of 52 patients who underwent sacral neuromodulation (SNM) lead electrode implantation under fluoroscopy or ultrasound guidance from July 2016 to July 2019. The operating time, number of electrode contacts with stimulus responses, minimum voltage that causes a stimulus response, and rate of standard lead electrode placement were used to assess the differences between the two methods. All patients were evaluated by recording bladder diaries, postvoid residual volumes before and during the testing period. Permanent SNM implantation is acceptable if symptoms improve by at least 50%. The operating time decreased from 87.1 ± 25.19 min in the X-ray group to 68.2 ± 25.20 min (p < 0.05) in the ultrasound group. The number of electrode contacts with stimulus responses, rate of standard lead electrode placement, and implantable pulse generator (IPG) placement rate were not significantly different between the two groups (p > 0.05). There was no radiation exposure during the operation in the ultrasound group. No incisional infections, hematomas, or other critical complications were reported in either groups. Ultrasound can be applied to safely place lead electrode for sacral neuromodulation and leads to no radiation exposure to the patient, surgeon, and operating room staff and a shortened operating time while maintaining the same efficacy as X-ray.

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