Glickman Urologic and Kidney Institute, Cleveland Clinic, 9500 Euclid Avenue, Q-10, Cleveland, OH, 44195, USA.
Curr Urol Rep. 2019 Aug 7;20(9):55. doi: 10.1007/s11934-019-0920-6.
Neuromodulation encompassing sacral and peripheral modalities is an established, effective, and safe higher-order treatment option approved in the USA for managing refractory overactive bladder, non-obstructive urinary retention, and fecal incontinence. This review highlights the most recent literature, indications, treatment durability, and the latest innovations in this field. Regarding sacral neuromodulation (SNM), recent work suggests improved parameters for optimal lead placement, increased data to support the lasting effects of treatment, and novel applications of this technology to other pelvic disorders. In addition, there are emerging technologies with smaller MRI compatible devices. Newer data on percutaneous tibial nerve stimulation (PTNS) suggests it may be more beneficial for certain patients. With new technology, implantable tibial nerve stimulators are ushering in a new frontier of nerve stimulation in the comfort of the patient's home.
神经调节包括骶神经和外周模式，是一种已被确立的、有效的、安全的高级治疗选择，已获得美国批准，用于治疗难治性膀胱过度活动症、非梗阻性尿潴留和粪便失禁。本综述重点介绍了该领域的最新文献、适应证、治疗持久性和最新创新。关于骶神经调节（SNM），最近的研究工作表明，优化了最佳导线放置的参数，增加了支持治疗持久效果的数据，并将该技术应用于其他骨盆疾病。此外，还有一些新兴技术采用了更小的 MRI 兼容设备。关于经皮胫神经刺激（PTNS）的新数据表明，它对某些患者可能更有益。随着新技术的出现，可植入的胫神经刺激器将在患者家中的舒适环境中开创神经刺激的新纪元。
