Bannowsky A, Seif C, Sugimoto S, Böhler G, van der Horst C, Bross S, Alken P, Jünemann K-P, Braun P M
Klinik für Urologie, Christian-Albrechts-Universität, Kiel.
Urologe A. 2003 Oct;42(10):1357-65. doi: 10.1007/s00120-003-0343-2. Epub 2003 Apr 4.
Over the last few years, sacral neuromodulation has become an established treatment option for dysfunctions of the lower urinary tract. It fills the gap that used to exist between conservative therapy and costly invasive methods such as urinary drainage via a deactivated bowel segment. Initially, the clinical value of sacral neuromodulation was controversial even among neurourologists. This was mainly due to a lack of understanding of the physiological processes, uncertain diagnostics, the design of the hardware, and a surgical topography relatively unknown to the urologist. In the meantime, however, sacral neuromodulation has become a standard part of clinical routine with respect to the treatment of dysfunctions of the lower urinary tract, and it is regularly employed in various urological institutions across Europe and the USA. This form of treatment, which is the final straw for patients who believed themselves-after many frustrated therapy attempts-to be "hopeless cases," can now also successfully be employed as an ambulatory measure. The latest data from our hospital, as well as contributions presented at the last DGU Congress in Wiesbaden, indicate that patients with neurogenic urinary retention are the most likely to profit from this treatment option.
在过去几年中，骶神经调节已成为下尿路功能障碍的一种既定治疗选择。它填补了过去保守治疗与诸如通过失活肠段进行尿液引流等昂贵侵入性方法之间存在的空白。最初，即使在神经泌尿科医生中，骶神经调节的临床价值也存在争议。这主要是由于对生理过程缺乏了解、诊断不确定、硬件设计以及泌尿外科医生相对不熟悉的手术解剖结构。然而，与此同时，就下尿路功能障碍的治疗而言，骶神经调节已成为临床常规的标准组成部分，并且在欧洲和美国的各个泌尿外科机构中经常使用。这种治疗形式，对于那些在多次沮丧的治疗尝试后认为自己是“无望病例”的患者来说是最后的希望，现在也可以成功地作为一种门诊治疗措施使用。我们医院的最新数据以及在威斯巴登举行的上一届德国泌尿外科学会大会上发表的报告表明，神经源性尿潴留患者最有可能从这种治疗选择中获益。
