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Title: Sacral Nerve Stimulation For Urinary Retention As A Sequalae Of Neuromyelitis Optica And Connective Tissue Disorder - Case Report
e-poster Number: INSIM78
Category: Neurology
Author Name: Guruprasad Hosurkar
Institute: Manipal hospitals, Yeshwanthpur, Bengaluru
Co-Author Name: Raghuram Gopalakrishnan
Abstract :
Management of bladder incontinence is one of the major therapeutic challenges secondary to MS, Neuromyelitis Optica or other spinal cord disorders. Patients continue to suffer poor quality of life, if this aspect is not tackled adequately. We present a 23yrs old lady who had symptoms of urinary retention, secondary to neurogenic bladder requiring self intermittent catheterisation atleast 3- 4 times in a day for last 3yrs. Her neurogenic bladder was a sequalae of neuromyelitis optica and connective tissue disorder, which otherwise was in good remission on immunosuppressives. She was independent for ambulation and other activities of daily living with no major residual motor weakness or visual symptoms now. However she could not travel or socialise because of the bladder issues, and was looking for alternative solution other than regular catheterisation. She underwent Interstim lead (medtronics) placement percutaneously at the right S3 foramen close to the s3 anterior root under fluoroscopy guidance and was connected to an external battery for test stimulation. IPG was implanted 2 days later once her perception of bladder sensation improved, she could self void consistently and satisfactorily. During the 3 months and 6 months followup, she was self voiding completely with no requirement for catheterisation. This has significantly improved her self esteem, quality of life, and is looking forward to conceive. Uroflowmetry showed significant reduction in post void residue. Sacral neuromodulation can be an effective therapeutic option for medically refractive bladder incontinence in carefully selected patients, even on a background of systemic illnesses.
