Estimulación de raíces sacras anteriores en pacientes con lesión medular: experiencia en 42 casos

Abstract

ObjectiveTo describe the results, in terms of effectiveness and morbidity of sacral neuro- stimulation (SARS) in patients with neurogenic detrusor overactivity. A comparison was made of the different aspects that can be modified by the sacral neurostimulator (SARS) in patients with neurogenic detrusor overactivity. Material and methodsThe study included 42 patients with complete spinal cord injury, and neurogenic detrusor overactivity, in whom a sacral neurostimulator was inserted over a period of two years in the Pablo Tobón Uribe Hospital. ResultsOf the 42 subjects, 90.5% (n=38) were male. The mean age of the patients was 38.6years (21-60), and 95.2% (n=40) had a history of symptomatic urinary tract infections (UTI). All (100%) of the patients were incontinent before the procedure, and 80% (n=32) had a cystometric capacity of less than 200ml. After the intervention, 87% (n=35) had a residual volume of less than 50ml. Urinary continence was achieved in 90.2% (n=37), and 85.3% (n=35) are free of episodes of UTI. ConclusionsSacral anterior neurostimulation is effective in spinal cord injury patients with neurogenic bladder overactivity. It is a safe procedure with a complications dependent learning curve that makes it a valid option in patients with spinal cord injury and patients with complications associated with detrusor and detrusor external sphincter overactivity. The additional benefit over the control of defecation and sexuality make this device a useful strategy in dealing with the aftermath of spinal cord injury.© 2011 Sociedad Colombiana de Urología. Published by Elsevier España, S.L. All rights reserved.