[Neurostimulation and neuromodulation in urinary incontinence]. / Neuroestimulación y neuromodulación en la incontinencia urinaria.

Electric stimulation in Urology has undergone considerable development since the 1970s. The implantation methods for urinary system stimulation are used for bladder emptying in neurogenic bladders (Neurostimulation) or the modulation of the electrical transmission of the voiding cycle caused by chronic detrusor-sphincter dysfunction (Neuromodulation). Both techniques have in common the direct stimulation of the sacral roots, responsible for the urinary reflex arc. The first of them works via external stimulation over an implanted antenna, and the second via permanent stimulation through an implanted pacemaker. We review in this article the indications, technique and results of both therapies, specially focused on the Spanish experience.

[Electric stimulation of sacral roots for the treatment of urinary incontinence due to detrusor instability: application of a technique and results in a clinical case]. / Estimulación eléctrica de raíces sacras para el tratamiento de la incontinencia urinaria por inestabilidad del detrusor: inicio de una técnica y resultado en un caso clínico.

OBJECTIVE: To describe a case treated with a new technique in our therapeutic algorithm for non-neurogenic vesicourethral dysfunction. METHODS/RESULTS: A 47-year-old female underwent retropubic urethropexy for stress urinary incontinence. She remained incontinent due to detrusor instability to a degree that was socially unacceptable. After conservative treatment had failed, a percutaneous electrode was applied to the sacral nerve root and she received electrical stimulation of 4-6 milliamperes, 15 Hz and 200 microseconds duration for 7 days. Incontinence remitted for as long as 3 months after the electrode had been removed. CONCLUSION: The results achieved with sacral nerve electrical stimulation reported in the literature and our results support the use of this technique in urological clinical practice.

[Current status of neurostimulation and neuromodulation for vesicourethral dysfunction]. / Estado actual de la neuroestimulación y neuromodulación para la disfunción vésicouretral.

OBJECTIVE: To describe the current indications, techniques and results of sacral root stimulation in patients with spinal cord lesions as a treatment for patients with high pressure bladders and/or urinary incontinence despite conservative management, as well as sacral root neuromodulation with permanent stimulators for complex bladder dysfunction: vesical instability, sensory urgency, chronic pelvic pain and chronic voiding dysfunction. METHODS/RESULTS: The literature is reviewed, both techniques are described and the results of the most significant series are discussed, with special reference to the first groups that utilized these techniques. CONCLUSIONS: There is ample experience in the application of sacral root electrical stimulation. The reported results are comparable with those achieved by other treatments, such as augmentation cystoplasty. Neurostimulation and neuromodulation techniques are simple, the complications are minimal and they do not prelude the use of other therapies.

[Obstructive uropathy in Gardner syndrome: a new case and an alternative therapeutic option]. / Uropatía obstructiva en el síndrome de Gardner: un nuevo caso y otra opción terapéutica.

Gardner's Syndrome comprises numerous pathological entities, one of which is the intraabdominal desmoid tumour which can provoke obstructive uropathy through ureteral trapping. Contribution of one case treated with resection of the trapped ureter, reanastomosis and plasty with peritoneal flap. Discussion of the diagnosis, evolution, and the different therapeutical choices found in the literature.