Gu Yinjun, Lv Tingting, Jiang Chen, Lv Jianwei
Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Neurosci. 2021 Feb 26;15:619672. doi: 10.3389/fnins.2021.619672. eCollection 2021.
Electrical stimulation of peripheral nerves by implanted electrodes is an effective treatment for certain pelvic floor diseases. As well as intravesical electrical stimulation, this predominantly includes stimulation of the sacral nerve, tibial nerve, and pudendal nerve. The pudendal nerve is one of the main nerves that stimulate pelvic floor muscles, external urethral meatus, and the anal sphincter and pelvic organs, and it may have effects on frequent urination, urgency, dysuria, and perineal pain. It is difficult to locate because of its anatomical course, however, leading to difficulties fixing the electrode, which increases the difficulty of pudendal nerve electrical stimulation in clinical practice. In the current study 3D printed navigation was used to solve these problems. Combined with autopsy data and patient pelvic and nerve data, a personalized design was generated. Neural modulation of the pudendal nerve was achieved by implanting the lead with the guidance of 3D printed navigation. 3D printed navigation can maximize the phase II conversion rate, reduce the difficulty of surgery, shorten the operation time, reduce damage to additional organs and blood vessels, and increase the accuracy of electrode implantation, and it can be performed while the patient is awake. It is an accurate, reversible, efficient, and minimally invasive surgery.
植入电极对周围神经进行电刺激是治疗某些盆底疾病的有效方法。除膀胱内电刺激外，主要还包括对骶神经、胫神经和阴部神经的刺激。阴部神经是刺激盆底肌肉、尿道外口、肛门括约肌和盆腔器官的主要神经之一，可能对尿频、尿急、排尿困难和会阴疼痛有影响。然而，由于其解剖走行，很难定位，导致电极固定困难，这增加了临床实践中阴部神经电刺激的难度。在本研究中，使用3D打印导航来解决这些问题。结合尸检数据以及患者盆腔和神经数据，生成个性化设计。通过在3D打印导航引导下植入导线实现阴部神经的神经调节。3D打印导航可使二期转化率最大化，降低手术难度，缩短手术时间，减少对其他器官和血管的损伤，提高电极植入的准确性，并且可以在患者清醒状态下进行。这是一种准确、可逆、高效且微创的手术。
