Peters Kenneth M
Department of Urology, William Beaumont Hospital, Royal Oak, MI, USA.
Int Urogynecol J. 2010 Dec;21(12):1559-63. doi: 10.1007/s00192-010-1282-2.
Bladder dysfunction is a very prevalent disorder and often refractory to behavioral and pharmacologic therapies. Sacral nerve stimulation is an approved method of managing urinary urgency, frequency, urge incontinence, and urinary retention. Alternative approaches to neuromodulation are being developed. The purpose of this paper is to describe emerging approaches to neuromodulation for voiding dysfunction. A current review of alternative methods of neuromodulation is discussed. This includes stimulation of the tibial nerve via a percutaneous approach, methods of stimulating the pudendal nerve to obtain afferent stimulation through sacral roots S2-S4, chemo-neuromodulation using botulinum toxin, and anogenital stimulation. These various methods are described and the current literature reviewed. Neuromodulation is an alternative to traditional management of voiding dysfunction. A benefit of neuromodulation is that it is minimally invasive and reversible. New sites of stimulation are being developed to add to our treatment options.
膀胱功能障碍是一种非常普遍的疾病，通常对行为疗法和药物疗法具有难治性。骶神经刺激是治疗尿急、尿频、急迫性尿失禁和尿潴留的一种已获批准的方法。正在开发神经调节的替代方法。本文的目的是描述用于排尿功能障碍的神经调节新方法。讨论了当前对神经调节替代方法的综述。这包括通过经皮途径刺激胫神经、刺激阴部神经以通过骶神经根S2 - S4获得传入刺激的方法、使用肉毒杆菌毒素的化学神经调节以及肛门生殖器刺激。描述了这些各种方法并综述了当前文献。神经调节是传统排尿功能障碍管理方法的一种替代方案。神经调节的一个优点是它微创且可逆。正在开发新的刺激部位以增加我们的治疗选择。
