Female Pelvic Medicine & Reconstructive Surgery, Glickman Urological and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Curr Urol Rep. 2012 Oct;13(5):363-9. doi: 10.1007/s11934-012-0268-7.
In the past decade, the use of sacral neuromodulation has increased exponentially. The introduction of the tined lead, the posterior location, and the smaller IPG has changed the frequency and types of complications. These facts explain the reduction of the revision and explantation rates in the most contemporary series, as compared with the earlier data. Infection, pain at the IPG site, and reduced clinical response with or without impedance abnormalities are now the most frequently reported complications. Although infection should be managed with explantation of the entire system, device interrogation should be part of the physician's algorithm for managing patients with decreased sensation or new onset of pain, in order to check the integrity of the system. Patients who are not improved with new programs will most likely need surgical revision. The implanting physician should be aware of the ways to evaluate and manage complications and suboptimal responses, to appropriately troubleshoot patients, and to reduce the need for surgical revision.
在过去的十年中，骶神经调节的应用呈指数级增长。叉状电极的引入、后位电极放置以及更小的 IPG 改变了并发症的频率和类型。与早期数据相比，这些事实解释了在最近的系列研究中，翻修和取出率的降低。目前，感染、IPG 部位疼痛以及临床反应降低伴或不伴阻抗异常是最常报告的并发症。尽管应通过取出整个系统来治疗感染，但在处理感觉减退或新出现疼痛的患者时，设备检测应成为医生算法的一部分，以检查系统的完整性。对于那些不能通过新程序改善的患者，最有可能需要手术翻修。植入医生应该了解评估和处理并发症以及不理想反应的方法，以便适当地为患者排除故障，并减少手术翻修的需求。
