Accepted Manuscript A New Technique of Laparoscopic Implantation of Stimulation Electrode to the Pudendal Nerve for Treatment of refractory Fecal incontinence and/or Overactive Bladder with Urinary Incontinence Possover Marc, MD, PhD PII:

S1553-4650(14)00059-4

DOI:

10.1016/j.jmig.2014.02.003

Reference:

JMIG 2251

To appear in:

The Journal of Minimally Invasive Gynecology

Received Date: 3 January 2014 Accepted Date: 1 February 2014

Please cite this article as: Marc P, A New Technique of Laparoscopic Implantation of Stimulation Electrode to the Pudendal Nerve for Treatment of refractory Fecal incontinence and/or Overactive Bladder with Urinary Incontinence, The Journal of Minimally Invasive Gynecology (2014), doi: 10.1016/ j.jmig.2014.02.003. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

*Manuscript Click here to view linked References

A New Technique of Laparoscopic Implantation of Stimulation Electrode to the Pudendal Nerve for Treatment of refractory Fecal incontinence and/or Overactive Bladder with Urinary Incontinence. Possover Marc, MD, PhD ABSTRACT

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Possover International Medical Center – Zuerich – Switzerland

Study Objective: To show a new technique of laparoscopic implantation of electrode for stimulation of the pudendal nerve for treatment of fecal incontinence and/or OAB with urinary incontinence. Design: Step-by-step explanation of the technique using videos and pictures (educative video).

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Setting: Hyperactivity of the bladder with urinary incontinence, especially the non-neurogenic form of the condition, but also fecal incontinence may affect millions of women over the world, without any co-morbidities and in particular without any neurologic disorders or prolapsed organs. First-line conservative treatments do not always lead to sufficient improvement of the complaints and are often associated with disabling adverse effects leading to treatment failure. Electrical stimulation of the pelvic nerves has emerged as an alternative and attractive treatment for refractory cases. A novel technique of implantation of an electrode to the pudendal nerve has been developed for treatment as well of fecal incontinence as of hyperactivity of the bladder with urinary incontinence. The laparoscopic approach is the only technique that enable placement of an electrode in direct contact to the endopelvic portion of the pudendal nerve within the protection of the pelvis. Interventions: Laparoscopic transperitoneal implantation of a stimulation electrode to the endopelvic portion of the pudendal nerve. Conclusion: This technique of transperitoneal placement of an electrode to the endopelvic portion of the pudendal nerve enables an effective, safe and reproducible day-procedure for treatment for intractable hyperactive bladder, urinary incontinence, fecal incontinence and the combination of both form of incontinences.

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Keywords: Pudendal Nerve Stimulation; OAB; Incontinence; Laparoscopy

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