Coloproctology Unit, Ospedale Regionale di Lugano, Lugano, Switzerland.
Department of Surgical and Medical Gastroenterology, Hvidovre University Hospital, Hvidovre, Denmark.
Neuromodulation. 2020 Dec;23(8):1121-1129. doi: 10.1111/ner.13117. Epub 2020 Mar 9.
In sacral neuromodulation (SNM), stimulation programming plays a key role to achieve success of the therapy. However to date, little attention has been given to the best ways to set and optimize SNM programming during the test and chronic stimulation phases of the procedure.
Standardize and make SNM programming easier and more efficient for the several conditions for which SNM is proposed.
Systematic literature review and collective clinical experience report.
The basic principles of SNM programming are described. It covers choice of electrode configuration, stimulation amplitude, pulse frequency and pulse widths, while use of cycling is also briefly discussed. Step-by-step practical flow charts developed by a group of 13 European experts are presented.
Programming of SNM therapy is not complex. There are few programming settings that seem beneficial or significantly impact patient outcomes. Only four basic electrode configurations could be identified according to four different options to define the cathode. In a majority of patients, the proposed stimulation parameters will allow a satisfactory improvement for long periods of time. A regular follow-up is, however, necessary to assess and eventually optimize results, as well as to reassure patients.
在骶神经调节（SNM）中，刺激编程在实现治疗成功方面起着关键作用。然而，迄今为止，人们很少关注在该程序的测试和慢性刺激阶段设置和优化 SNM 编程的最佳方法。
为 SNM 提出的几种情况标准化并简化 SNM 编程，使其更高效。
系统文献回顾和集体临床经验报告。
描述了 SNM 编程的基本原则。它涵盖了电极配置、刺激幅度、脉冲频率和脉冲宽度的选择，同时还简要讨论了循环的使用。由 13 位欧洲专家组成的小组制定了逐步实用的流程图。
SNM 治疗的编程并不复杂。只有少数编程设置似乎有益或对患者的治疗效果有显著影响。根据定义阴极的四个不同选项，仅能确定四种基本的电极配置。对于大多数患者，所提出的刺激参数将在很长一段时间内允许令人满意的改善。然而，需要定期进行随访以评估和最终优化结果，并让患者安心。
