ADELAIDE SPECIALIST INCONTINENCE SERVICES
The Home of Pelvic Floor & Bladder Control Problems in South Australia
NEUROMODULATION
Fax: [08] 8332 5586
The function of the Lower Urinary Tract is mediated by 3 sets of nerve fibres:
1. The pelvic parasympathetic nerves [S3] - these stimulate the bladder to contract to facilitate voiding.
2. The lower lumbar sympathetic nerves [L1,2] - these contract the urinary sphincter and relax the bladder. They may also dampen the detrusor contraction to assist controlled voiding.
3. Pudendal nerves which excite the striated sphincter and elements of the pelvic floor.
Stimulating [neuromodulating] the S3 sacral nerve root has been shown to inhibit overactive uninhibited detrusor contractions, restoring normal voluntary voiding and reducing urgency and urge incontinence of urine [and faeces].
Generally such problems are long term and controlled with anticholinergic medications such as Ditropan, Detrusitol, Solifenacin, Darifenacin or Oxytrol patches.
If this treatment is unsuccessful, consideration should be given to the modulation of the neural control of the bladder with electrical stimulation of the 3rd Sacral nerve root via a stimulating electrode and pulse generator [pacemaker].
This simple, exceedingly safe procedure has been shown in most centres to achieve 70% success in this extremely difficult problem.
The procedure is performed in two stages with a successful external pacing phase followed by insertion of the pulse generator.
Dr Tucker pioneered this procedure in the mid 1990’s in Australia and has taught the procedure to many other Urogynaecologists and Urologists in Australia and New Zealand.
More recently Dr Tucker has been responsible for advances in this technique with modifications to the lead giving a lesser risk of inward migration of the lead.
Inserting the test needle to identify 3rd sacral foramen and nerve
· REFRACTORY DETRUSOR OVERACTIVITY
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Phone: [08] 8332 1111
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Suite 2, 128 Fullarton Road
Norwood SA 5067
ADELAIDE SPECIALIST INCONTINENCE SERVICES
Sacral Nerve Stimulating Elactrode
