AIM:Neurogenic low urinary tract dysfunctions unresponsive to medical and conservative therapy are difficult to manage. Nowadays they can be treated with Sacral Nerve Stimulation (SNS), even if clinical experiences reported in literature are still limited.METHODS:We performed SNS in 6 patients with neurogenic bladder: 3 patients had incontinence-urgency (1 myelitis, 1 multiple sclerosis, 1 autonomic polineuropathy) and 3 patients had urinary retention (1 incomplete spinal cord lesion, 1 operation for discal hernia T5-T6, 1 hysterectomy).RESULTS:Among cases with incontinence-urgency we achieved complete control of the bladder in 2 patients while in 1 patient the number of urinary losses was reduced of the 80%. In 2 patients with urinary retention we obtained complete recovery of the bladder function, while in 1 patient the number of cateterisms/die reduced of 50%, the urinary volume for micturion increased and residual urinary volume decreased. Results were unchanged during the follow-up (maximum 26 months), except for 1 patient in which a partial loss of effectiveness occurred.CONCLUSIONS:Chronic electric stimulation of S3 sacral roots via an implanted neuroprotesis is therefore an effectiveness, save and promising therapeutic option in treatment of neurogenic bladder dysfunctions.

Dystonia is a clinical syndrome characterized by involuntary muscle contractions frequently causing repetitive, twisting movements or abnormal postures which are sometime painful. It is the third most common movement disorder after Parkinson’s Disease and Tremor, affecting more then 20,000 people in Italy. Dystonia is classified in three ways: by age of onset (childhood-onset, adolescence-onset and adult-onset), by body distribution of symptoms (focal, segmental, multifocal, generalized, and hemidystonia) and by etiology (primary hereditary or sporadic and secondary). Moreover, on the basis of involuntary movements types, we distinguish “mobile dystonia” (abnormal patterned or slow movements) from “fixed dystonia” (abnormal posture).