Yamashiro Justine, de Riese Werner, de Riese Cornelia
School of Medicine, Texas Tech University Health Science Center, Lubbock, TX, USA.
Department of Urology, Texas Tech University Health Science Center, Lubbock, TX, USA.
Res Rep Urol. 2019 Dec 23;11:351-357. doi: 10.2147/RRU.S231954. eCollection 2019.
The purpose of this review is to offer an update for medical providers practicing general urology and urogynecology in evolving and new promising technologies for neuromodulation in patients with OAB.
A focused literature search for the years 2015 through 2019 was conducted on PubMed/Medline for the terms: "new techniques" AND "neuromodulation" AND "tibial nerve stimulation" AND "overactive bladder". We limited our search to publications in English, for the last five years and with patient follow-up of at least 3 months.
Clinical success, safety based on adverse events, and quality of life improvement criteria were evaluated and compared to sacral nerve stimulation (SNS) devices and older, non-implantable percutaneous tibial nerve stimulation (PTNS) treatment devices. Considering the limited number of participants with up to 6 months follow-up data currently available, overall the clinical response rates suggest that the new implantable devices stimulating the tibial nerve have a promising clinical outlook, are less invasive upon implantation than SNS, less expensive, and less of a burden on patients compared to the older non-implantable PTNS devices.
Practicing urologists should be aware of this new treatment option when counseling their patients regarding treatment for OAB.
本综述旨在为从事普通泌尿外科和女性盆底重建外科的医疗人员，提供有关膀胱过度活动症（OAB）患者神经调节方面不断发展的新的有前景技术的最新信息。
在PubMed/Medline上对2015年至2019年期间进行了重点文献检索，检索词为：“新技术”、“神经调节”、“胫神经刺激”和“膀胱过度活动症”。我们将检索范围限制为过去五年内的英文出版物，且患者随访时间至少为3个月。
对临床成功率、基于不良事件的安全性以及生活质量改善标准进行了评估，并与骶神经刺激（SNS）设备和较旧的、不可植入的经皮胫神经刺激（PTNS）治疗设备进行了比较。考虑到目前仅有有限数量的参与者有长达6个月的随访数据，总体而言，临床反应率表明，新型可植入胫神经刺激设备具有良好的临床前景，植入时的侵入性比SNS小，成本更低，与较旧的不可植入PTNS设备相比，给患者带来的负担也更小。
在为OAB患者提供治疗咨询时，执业泌尿科医生应了解这种新的治疗选择。
