Definition

Urinary incontinence less often requires surgery more used technique: neuromodulation.

Medical technique

Surgical techniques include before all the entérocystoplastie expansion (clam-cystoplastie) which the technique has been developed by Bramble in 1982 (patch ileal détubulisé with suture for bladder opened in bivalve). However, after such interventions, in the majority of cases (i.e. about 90%), surveys are useful because there is always a certain amount of residual urine after emptying of the bladder (postmictionnel residue).Besides this intervention developed by Bramble, there are other conventional operations, including (non-exhaustive list):

• The suspension of the neck of the bladder, which is intended to correct the excessive mobility of the urethra (the canal carrying urine to the bladder).
• The correction of the inadequate functioning of the sphincters.
• The suspension of the neck of the bladder (colposuspension Burch retropubic) particularly effective.

Another technique, the suspension by transobturatrice Strip (TOT) to suspend laterally the bladder, also gives good results.Neuromodulation is a technique consisting of an electrically stimulate the sacred nerves and specifically nerve roots out of the spinal cord at the basin level third sacral). Stimulation of root S3 is intended to become of the malfunction of the bladder (bladder dysfunction).Neuromodulation is a technique used when there is a dysfunction of the urinary bladder: rétentionniste bladder (retaining urine) or overactive bladder (spilling excessively urine).  This technique involves two steps. It is first necessary to make a simulation test is followed by final, when implementing the positive response of stimulation electrodes.The absence (or the absence) of adverse effects after use of neuromodulation is one of the big advantages of this technique. However, this technique while less aggressive than the surgery is still invasive over treatments using drugs or a re-education.

Bibliography

Barat M, Egon g. Daverat P. et al: stimulation of the earlier sacred roots in the treatment of neuro bladders Central Technique of Brindley GS results of the first 40 French cases. Journal Urology (Paris) 1993.  99 (1) 3 – 7 .tanagho EA: Concept of neuromodulation. Neurourol. Urodyn. 1993 12 487 – 488