The Experts below are selected from a list of 15 Experts worldwide ranked by ideXlab platform
Steven A Stiens - One of the best experts on this subject based on the ideXlab platform.
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abdominal electric stimulation facilitates penile vibratory stimulation for ejaculation after spinal cord injury a single subject trial
Archives of Physical Medicine and Rehabilitation, 2005Co-Authors: Lance L Goetz, Steven A StiensAbstract:Abstract Goetz LL, Stiens SA. Abdominal electric stimulation facilitates penile vibratory stimulation for ejaculation after spinal cord injury: a single-subject trial. Objective To compare the success rate of penile vibratory stimulation (PVS) alone with PVS and abdominal electric stimulation (AES). Design Single-subject trials. Setting Outpatient. Participant Man with chronic T3 complete (American Spinal Injury Association Impairment Scale grade A) spinal cord injury. Spasticity, Babinski response, Anal Wink, and bulbocavernosus reflexes were all present. Intervention Stimulation was presented to the frenulum using a Ferti Care Personal vibrator set at maximal settings (frequency, 110Hz; amplitude, 3.55mm). AES was applied to the abdomen using a commercially available muscle stimulator at maximal stimulus intensity and duration settings. Trials were randomized to PVS only or PVS plus AES. Main Outcome Measures Presence or absence of ejaculation, and time to ejaculation. Results Only 4 of 30 trials were positive with PVS alone, while 31 of 34 trials were positive with PVS plus AES. Additionally, 17 of 26 PVS trials, which were initially negative with PVS alone, were then positive with the addition of AES. This represents a clinically relevant improvement with use of AES. Time to ejaculation for positive trials with either technique was not statistically significant. Conclusions AES significantly lowered the threshold for ejaculation elicited with vibratory stimulation and increased the success rate over that when PVS alone was used.
Lance L Goetz - One of the best experts on this subject based on the ideXlab platform.
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abdominal electric stimulation facilitates penile vibratory stimulation for ejaculation after spinal cord injury a single subject trial
Archives of Physical Medicine and Rehabilitation, 2005Co-Authors: Lance L Goetz, Steven A StiensAbstract:Abstract Goetz LL, Stiens SA. Abdominal electric stimulation facilitates penile vibratory stimulation for ejaculation after spinal cord injury: a single-subject trial. Objective To compare the success rate of penile vibratory stimulation (PVS) alone with PVS and abdominal electric stimulation (AES). Design Single-subject trials. Setting Outpatient. Participant Man with chronic T3 complete (American Spinal Injury Association Impairment Scale grade A) spinal cord injury. Spasticity, Babinski response, Anal Wink, and bulbocavernosus reflexes were all present. Intervention Stimulation was presented to the frenulum using a Ferti Care Personal vibrator set at maximal settings (frequency, 110Hz; amplitude, 3.55mm). AES was applied to the abdomen using a commercially available muscle stimulator at maximal stimulus intensity and duration settings. Trials were randomized to PVS only or PVS plus AES. Main Outcome Measures Presence or absence of ejaculation, and time to ejaculation. Results Only 4 of 30 trials were positive with PVS alone, while 31 of 34 trials were positive with PVS plus AES. Additionally, 17 of 26 PVS trials, which were initially negative with PVS alone, were then positive with the addition of AES. This represents a clinically relevant improvement with use of AES. Time to ejaculation for positive trials with either technique was not statistically significant. Conclusions AES significantly lowered the threshold for ejaculation elicited with vibratory stimulation and increased the success rate over that when PVS alone was used.
Michael Craggs - One of the best experts on this subject based on the ideXlab platform.
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studies of the latency of pelvic floor contraction during peripheral nerve evaluation show that the muscle response is reflexly mediated
The Journal of Urology, 2000Co-Authors: Clare J Fowler, Michael J Swinn, R J Goodwin, S Oliver, Michael CraggsAbstract:Purpose: Whether neuromodulation using an implanted sacral nerve stimulator acts by its effects on pelvic afferent or efferent nerves remains to be determined. However, it has been observed that eliciting an "Anal Wink" is helpful in the optimal siting of the foraminal stimulating electrode. This observation has been interpreted as indicating that a direct effect on efferent pelvic innervation is an important functional component of the technique. We studied the latency of this motor response to determine whether it is consistent with neuromodulation working via a direct efferent mechanism. Materials and Methods: We studied 9 women with urinary retention undergoing the first stage of a stimulator implant (peripheral nerve evaluation). Stimulation was applied to an electrode placed in the S3 foramen and the latency of the response of the striated Anal sphincter, a contraction which gives rise to the "Anal Wink," was measured using a concentric needle electrode placed in the striated part of the Anal sphincter. Results: Mean latency of response was 98 milliseconds (range 52 to 140), which is approximately 10 times longer than would be expected from that resulting from direct motor nerve stimulation. Conclusions: Our results indicate that Anal sphincter contraction observed during peripheral nerve evaluation is the result of an afferent mediated response.
Clare J Fowler - One of the best experts on this subject based on the ideXlab platform.
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studies of the latency of pelvic floor contraction during peripheral nerve evaluation show that the muscle response is reflexly mediated
The Journal of Urology, 2000Co-Authors: Clare J Fowler, Michael J Swinn, R J Goodwin, S Oliver, Michael CraggsAbstract:Purpose: Whether neuromodulation using an implanted sacral nerve stimulator acts by its effects on pelvic afferent or efferent nerves remains to be determined. However, it has been observed that eliciting an "Anal Wink" is helpful in the optimal siting of the foraminal stimulating electrode. This observation has been interpreted as indicating that a direct effect on efferent pelvic innervation is an important functional component of the technique. We studied the latency of this motor response to determine whether it is consistent with neuromodulation working via a direct efferent mechanism. Materials and Methods: We studied 9 women with urinary retention undergoing the first stage of a stimulator implant (peripheral nerve evaluation). Stimulation was applied to an electrode placed in the S3 foramen and the latency of the response of the striated Anal sphincter, a contraction which gives rise to the "Anal Wink," was measured using a concentric needle electrode placed in the striated part of the Anal sphincter. Results: Mean latency of response was 98 milliseconds (range 52 to 140), which is approximately 10 times longer than would be expected from that resulting from direct motor nerve stimulation. Conclusions: Our results indicate that Anal sphincter contraction observed during peripheral nerve evaluation is the result of an afferent mediated response.
Mandeep S Dhillon - One of the best experts on this subject based on the ideXlab platform.
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outcome of spinal decompression in cauda equina syndrome presenting late in developing countries case series of 50 cases
European Spine Journal, 2011Co-Authors: Sarvdeep S Dhatt, Sujit Kumar Tripathy, Naveen Tahasildar, Raj Bahadur, Mandeep S DhillonAbstract:The purpose of this study is to find the clinical outcome of decompression of Cauda Equina presenting late in the course of disease. There were 33 males and 17 females with average age of 48 years, ranging from 25 to 85 years. All patients presented to us with a fully developed Cauda Equina syndrome (CES). All of them presented late with mean delay of 12.2 days. Time interval between bladder and bowel dysfunction and admission to hospital varied from 1 to 35 days. The average follow-up was 34.5 months, ranging from 12 to 60 months. There was no statistically significant difference in time of delay in surgery between the recovered and non-recovered group as tested by Student’s t test. But there was a statistically significant positive correlation between duration taken for total recovery and delay in surgery. Anal Wink as a predictor of bladder and bowel recovery also showed statistical significance, as patients with an absence had a poorer prognosis for bladder recovery. The result of surgery in CES is not as dramatic and fast as seen after routine disc surgery. Some improvement can be expected with decompression even in those patients presenting late and results are not universally poor as previously thought. The treating physicians of such patients should be aware that the recovery in this group of patients can take an exceptionally long time and hence should involve in constant reassurance and rehabilitation of the patient. Presence of Anal Wink is a very good predictor of bladder and bowel recovery.