What is sacral nerve electrical stimulation?

Sacral nerve stimulation was first used in the treatment of neurogenic incontinence from the 1940s. 1963 Caldwell reported the use of implanted electrodes to stimulate the pelvic floor in the treatment of stress incontinence. 1976 Bridnley et al. in the UK and 1981 Tanagho et al. in the USA applied the sacral nerve electrical stimulation technique to humans and achieved good results in the treatment of urinary incontinence. 1995 Miaezl reported this technique for the treatment of fecal incontinence. In 1995, Miaezl reported this technique for the treatment of fecal incontinence. In our hospital, sacral nerve stimulation (SNS) is now mostly used in the treatment of constipation. The mechanism of sacral nerve stimulation in the treatment of defecation disorders The external sphincter and pelvic floor muscles are innervated by the sacral nerves that originate from the sacral segment of the crura medullaris. Stimulation of the motor nerve enhances sphincter contraction and promotes the conversion of the external sphincter into a fatigue-resistant muscle; stimulation of the sensory nerve improves the sensation of stool and regulates the local defecation reflex. Sacral nerve stimulation causes the nerve fibers of the left 1/3 transverse colon, descending colon and recto-anal canal to be stimulated, leading to rectal contraction and defecation in some patients, shortening defecation time; improving sigmoid peristalsis and reducing the occurrence of constipation; training the strength of external sphincter without causing contraction of regurgitant muscles at low voltage, which is conducive to improving stress urinary and fecal incontinence when abdominal pressure is increased; leading to a slight increase in pelvic floor and sphincter strength, correcting the inappropriate relaxation. Implementation of sacral nerve electrical stimulation treatment 1.Preparation Sacral nerve electrical stimulation should have targeted selection of acupuncture sites. Before treatment, the therapist should explain to the patient the physiopathological knowledge of constipation or anal incontinence, the purpose and process of treatment, so that the patient can fully understand the condition and cooperate. (2) Connect the puncture needle and the instrument, attach the electrode piece connected with the instrument to the patient’s buttocks, disinfect routinely, and lay a sterile towel; (3) After local anesthesia with 1% lidocaine, put an insulated needle through the S3 or S4 nerve hole percutaneously, and electrically stimulate to test Sensory and motor nerve root responses were tested. When a typical response was obtained, an insulated guide wire was inserted through the puncture needle into the sacral nerve foramen as a temporary electrode, and the puncture needle was fixed and connected to an external stimulator. The stimulation parameters are mostly frequency 2Hz, amplitude 1.5ms, and current size 1.5-6.0mA. 3. Treatment course If the patient is treated once every other day, 12 times of treatment will be a course of treatment; if once daily, 12 consecutive treatments will be a course of treatment.