Balog Brian M, Deng Kangli, Labhasetwar Vinod, Jones Kathryn J, Damaser Margot S
Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic.
Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland.
Curr Opin Urol. 2019 Jul;29(4):458-465. doi: 10.1097/MOU.0000000000000632.
The present review highlights regenerative electrical stimulation (RES) as potential future treatment options for patients with nerve injuries leading to urological dysfunction, such as urinary incontinence, voiding dysfunction or erectile dysfunction. Additionally, it will highlight the mechanism of nerve injury and regeneration as well as similarities and differences between RES and current electrical stimulation treatments in urology, functional electrical stimulation (FES) and neuromodulation.
It has been demonstrated that RES upregulates brain-derived neurotrophic factor (BDNF) and its receptor to facilitate neuroregeneration, facilitating accurate reinnervation of muscles by motoneurons. Further, RES upregulates growth factors in glial cells. Within the past 2 years, RES of the pudendal nerve upregulated BDNF in Onuf's nucleus, the cell bodies of motoneurons that course through the pudendal nerve and accelerated functional recovery in an animal model of stress urinary incontinence. Additionally, electrical stimulation of the vaginal tissue in an animal model of stress urinary incontinence accelerated functional recovery.
RES has great potential but future research is needed to expand the potential beneficial effects of RES in the field of urology.
本综述强调再生电刺激（RES）作为未来可能的治疗选择，用于治疗因神经损伤导致泌尿系统功能障碍的患者，如尿失禁、排尿功能障碍或勃起功能障碍。此外，还将强调神经损伤与再生的机制，以及RES与当前泌尿外科电刺激治疗、功能性电刺激（FES）和神经调节之间的异同。
已证明RES可上调脑源性神经营养因子（BDNF）及其受体，以促进神经再生，便于运动神经元对肌肉进行精确的再支配。此外，RES可上调神经胶质细胞中的生长因子。在过去两年中，在压力性尿失禁动物模型中，阴部神经的RES上调了奥努夫核中的BDNF，奥努夫核是通过阴部神经的运动神经元的细胞体，并加速了功能恢复。此外，在压力性尿失禁动物模型中，对阴道组织进行电刺激可加速功能恢复。
RES具有巨大潜力，但未来需要开展研究以扩大RES在泌尿外科领域的潜在有益作用。
