Pelvic floor activation upon stimulation of the sacral spinal nerves in sacral neuromodulation patients

• DOI: 10.1002/nau.24425
• Publication Date: 2020-06-25T17:03:02Z
• Authors: Donald Vaganée; Jeroen Voorham; Sigrid Van de Borne; Petra Voorham‐van...; Erik Fransen; Stefan De Wachter
• Keywords: Neuromodulation; External anal sphincter; Lead (geology); Intensity

Abstract Purpose To assess the activation of different parts pelvic floor muscles (PFM) upon electrical stimulation sacral spinal nerves while comparing lead electrode configurations. Material and Methods PFM electromyography (EMG) was recorded using an intravaginal multiple array probe with 12 electrodes pairs, which allows to make a distinction between sides depths floor. In addition concentric needle EMG external anal sphincter performed exclude far‐field recording. A medtronic InterStim tined (model 3889) used as source. Standard SNM parameters (monophasic pulsed square wave, 210 microseconds, 14 Hz) were stimulate five bipolar configurations (3+0−/3+2−/3+1−/0+3−/1+3−) up around sensory threshold. Of each signal intensity needed evoke signals well its amplitude latency determined. Linear mixed models analyse data. Results Twenty female patients 100 stimulated response threshold resulting in 722 stimulations times many (8664) recordings. significant increase seen increasing ( P < .0001). Large differences noted at (ipsilateral>posterior>anterior>contralateral) (deep>center>superficial) These for all Larger amplitudes measured when active located near entry point through foramen (electrode #3). No could be withheld, most likely due neuroanatomy > .05). Conclusions distinct pattern identified Electrical proximal #3) one elicited largest contractions.