Smits Martijn A C, Marcelissen Tom A T, van Kerrebroeck Philip E V, de Wachter Stefan G G
Maastricht Universitair Medisch Centrum, afd. Urologie, Maastricht, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(33):A4135.
Neuromodulation is used as a treatment for overactive bladder syndrome, if conservative management is ineffective or only partially effective. Sacral neuromodulation is now a minimally invasive treatment as a result of improvements in surgical technique, and it has good long-term results. Nevertheless the risk of complications such as pain and decreasing effect is still present. Developments in alternative neuromodulation treatments, such as posterior tibial nerve stimulation, pudendal nerve stimulation and intravesical injection therapy with botulinum neurotoxin, have extended the role of neuromodulation. Intravesical injection therapy with botulinum toxin, along with sacral neuromodulation, has been included in the treatment algorithm of overactive bladder syndrome if this does not respond to conservative therapy. When choosing for a neuromodulation therapy, the side-effects and complications of the treatments should be considered alongside the specific patient situation and evidence for effectiveness and long-term effectiveness.
如果保守治疗无效或仅部分有效，神经调节可用于治疗膀胱过度活动症。由于手术技术的改进，骶神经调节现在是一种微创治疗方法，并且具有良好的长期效果。然而，疼痛和疗效降低等并发症风险仍然存在。替代性神经调节治疗方法的发展，如胫后神经刺激、阴部神经刺激和肉毒杆菌神经毒素膀胱内注射治疗，扩大了神经调节的作用。如果膀胱过度活动症对保守治疗无反应，肉毒杆菌毒素膀胱内注射治疗与骶神经调节一起已被纳入其治疗方案。在选择神经调节治疗时，应结合特定患者情况以及有效性和长期有效性的证据，考虑治疗的副作用和并发症。
