Pelvic Medicine and Reconstructive Surgery, Arthur Smith Institute for Urology, North Shore - Long Island Jewish Healthcare System, 450 Lakeville Road, Suite M41, New Hyde Park, NY 11040, USA.
Curr Urol Rep. 2010 Sep;11(5):310-4. doi: 10.1007/s11934-010-0128-2.
Sacral neuromodulation is increasingly used for the treatment of voiding dysfunction, pelvic pain syndromes, and gastrointestinal disorders. While increased use of this technology has led to a greater understanding of its potential as well as its limitations, difficulty persists in identifying the patients that will benefit most. Either of two trial stimulation techniques is performed before placement of a permanent neuromodulator: the monopolar percutaneous nerve evaluation and the tined quadripolar staged trial. The preponderance of recent literature asserts the superior sensitivity of the staged trial over percutaneous nerve evaluation. However, the techniques offer disparate advantages, and other issues, such as cost-effectiveness, remain largely unexplored. The role of sacral neuromodulation will continue to expand as physicians and patients become increasingly aware of its therapeutic potential. Widespread adoption of this clinically superior technique will most rapidly help the greatest number of patients.
骶神经调节越来越多地用于治疗排尿功能障碍、盆腔疼痛综合征和胃肠道疾病。虽然这项技术的使用增加了对其潜在用途及其局限性的认识，但仍然难以确定哪些患者将受益最大。在放置永久性神经调节剂之前，通常会进行两种试验性刺激技术：单极经皮神经评估和有齿四极分级试验。最近的大量文献断言，分级试验比经皮神经评估具有更高的敏感性。然而，这些技术具有不同的优势，其他问题，如成本效益，在很大程度上仍未得到探索。随着医生和患者越来越意识到其治疗潜力，骶神经调节的作用将继续扩大。这种临床效果更优的技术的广泛应用将最快地帮助到最多的患者。
