van Balken M R, Vandoninck V, Gisolf K W, Vergunst H, Kiemeney L A, Debruyne F M, Bemelmans B L
Department of Urology, Canisius-Wilhemina Hospital, University Medical Centre, Nijmegen, The Netherlands.
J Urol. 2001 Sep;166(3):914-8. doi: 10.1097/00005392-200109000-00025.
Recently, intermittent percutaneous posterior tibial nerve stimulation was introduced as a treatment modality filling the gap between conservative and surgical therapies in patients with certain types of lower urinary tract dysfunction.
In a prospective multicenter trial posterior tibial nerve stimulation was evaluated in 37 patients who presented with symptoms of bladder overactivity, that is the urgency and frequency syndrome and/or urge incontinence, and 12 with nonobstructive urinary retention. Results were recorded in voiding diaries and on quality of life questionnaires before and after treatment. Patients were classified as responders, including those in whom therapy was successful and chose to continue treatment after the initial 12 weeks, and nonresponders, those who chose to stop treatment.
Overall, a positive response was seen in 60% of all patients. In patients with bladder overactivity a statistically significant decrease was observed in leakage episodes, number of pads used, voiding frequency and nocturia, and an equal increase in mean and smallest volume voided. Improvements were also seen in nonobstructive urinary retention, including number of catheterizations, total and mean volume catheterized, and total and mean volume voided. Disease specific quality of life and some domains of general quality of life improved, especially of bladder overactivity. Only mild side effects were observed.
Posterior tibial nerve stimulation is a minimally invasive and successful treatment option for patients with certain types of lower urinary tract dysfunction.
最近，间歇性经皮胫后神经刺激作为一种治疗方式被引入，以填补某些类型下尿路功能障碍患者保守治疗和手术治疗之间的空白。
在一项前瞻性多中心试验中，对37例表现为膀胱过度活动症状（即尿急尿频综合征和/或急迫性尿失禁）的患者以及12例非梗阻性尿潴留患者进行了胫后神经刺激评估。在治疗前后通过排尿日记和生活质量问卷记录结果。患者被分为反应者（包括治疗成功并在最初12周后选择继续治疗的患者）和无反应者（即选择停止治疗的患者）。
总体而言，60%的患者有阳性反应。膀胱过度活动患者的漏尿次数、使用尿垫数量、排尿频率和夜尿次数在统计学上显著减少，平均排尿量和最小排尿量均有同等程度增加。非梗阻性尿潴留患者也有改善，包括导尿次数、导尿总量和平均量以及排尿总量和平均量。特定疾病的生活质量和一般生活质量的某些领域有所改善，尤其是膀胱过度活动患者。仅观察到轻微的副作用。
胫后神经刺激对于某些类型下尿路功能障碍患者是一种微创且成功的治疗选择。
