What is sacral nerve electrical stimulation?

Sacral nerve stimulation has been used since the 1940s for the treatment of neurogenic urinary incontinence, and was reported by Caldwell in 1963 for the treatment of stress urinary incontinence with the use of implanted electrodes to stimulate the pelvic floor, and by Bridnley et al. in 1976 in the United Kingdom, and Tanagho et al. in 1981 in the United States, for the treatment of incontinence in humans, with good results. 1995, Miaezl reported this technique for the treatment of fecal incontinence. In 1995, Miaezl reported that this technique was used to treat fecal incontinence. Nowadays, sacral nerve stimulation (SNS) is mostly used in the treatment of constipation in our hospital. The mechanism of sacral nerve stimulation in the treatment of defecation disorders is that the external sphincter and the pelvic floor muscles are innervated by the sacral nerves originating from the sacral segment of the cremasteric medulla. Stimulation of the motor nerves enhances sphincter contraction and promotes the transformation of the external sphincter into a fatigue-resistant muscle; stimulation of the sensory nerves improves the sensation of stool and regulates the local defecation reflex. Sacral nerve stimulation makes the nerve fibers of the left 1/3 transverse colon, descending colon and recto-anal tube stimulated, leading to rectal contraction and defecation in some patients, shortening the time of defecation; improves the peristalsis of the sigmoid colon and reduces the incidence of constipation; the external sphincter strength can be trained under low voltage without causing contraction of the detrusor muscle, which is conducive to the improvement of stress incontinence when the abdominal pressure is increased; leads to a slight enhancement of pelvic floor and sphincter strength, and corrects the pelvic floor’s inappropriate relaxation. The implementation of sacral nerve electrical stimulation therapy 1, the preparation of sacral nerve electrical stimulation should be targeted to select the site of acupuncture, the therapist should explain to the patient before the treatment of constipation or anal incontinence of physiopathological knowledge, therapeutic purpose and process, so that the patient fully understand and cooperate with the condition. 2, the operation step (1) the patient to take the prone position, abdominal cushion elevated, exposure of buttocks, palpation to determine appropriate sacral mark, according to the anatomical location of the selection of puncture points; (2) the patient to take a prone position, abdomen padded, exposed buttocks, palpation to determine appropriate sacral mark, according to the anatomical position Select the puncture point according to the anatomical position; (2) Connect the puncture needle and the instrument, attach the electrode sheet connected to the instrument to the patient’s buttocks, routinely disinfected, and lay a sterile towel; (3) After local anesthesia with 1% lidocaine, an insulated needle will be inserted into the S3 or S4 neural foramen percutaneously, and electrical stimulation is performed to test the response of the sensory and motor nerve roots. When a typical response was obtained, an insulated guidewire was inserted into the sacral foramen via the puncture needle as a temporary electrode, and the puncture needle was fixed and connected to an external stimulator. Stimulation parameters are frequency 2Hz, amplitude 1.5ms, and current size 1.5-6.0mA.3. Course of treatment If the patient is treated once every other day, 12 times of treatment is a course of treatment; if once a day, 12 times of continuous treatment is a course of treatment.