Division of Urogynecology, Magee Womens Hospital, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.
Curr Opin Obstet Gynecol. 2012 Oct;24(5):331-6. doi: 10.1097/GCO.0b013e3283573ff9.
To provide an overview of sacral neuromodulation (SNM) and intravesical botulinum toxin (BTX) injections in the treatment of refractory overactive bladder (OAB) and urge urinary incontinence.
SNM has been a successful treatment option for OAB for over a decade with efficacy rates reported between 50 and 90%. Recently, intravesical BTX has been studied as a less invasive but more transient option with similar efficacy rates. Side-effect profiles differ greatly between the treatments, with elevated postvoid residuals and urinary tract infections most commonly occurring after botulinum injection and pain or device revision or removal occurring with SNM. Recent studies have tried to elucidate the optimal dosing regimen for BTX and patient variables predicting success for both therapies in order to improve outcomes while reducing adverse events.
Both intravesical BTX and SNM have been shown to be effective treatment options for OAB. Further research is needed to determine equivalence or if one therapy is superior and to identify the ideal patient population for each therapy.
介绍骶神经调节（SNM）和膀胱内肉毒杆菌毒素（BTX）注射治疗难治性膀胱过度活动症（OAB）和急迫性尿失禁的方法。
SNM 治疗 OAB 已有十余年，有效率为 50%至 90%。最近，膀胱内 BTX 作为一种侵袭性更小但更短暂的选择得到了研究，其疗效相似。两种治疗方法的副作用谱差异很大，BTX 注射后最常出现残余尿量增加和尿路感染，而 SNM 则常出现疼痛或装置修订或移除。最近的研究试图阐明 BTX 的最佳剂量方案以及两种治疗方法的患者变量预测成功率，以改善结果，同时减少不良反应。
膀胱内 BTX 和 SNM 均已被证明是治疗 OAB 的有效方法。需要进一步研究以确定两种治疗方法是否等效或哪种治疗方法更优，并确定每种治疗方法的理想患者人群。
