非适应证用药但靶向精准：骶神经调节治疗神经源性膀胱功能障碍
Off-Label but On-Target: Sacral Neuromodulation for Neurogenic Bladder Dysfunction.
作者信息
Vogel Keianna, Nakib Nissrine
机构信息
Department of Urology, University of Minnesota, Minneapolis, 420 Delaware St SE, MMC 394, MN, 55455, USA.
出版信息
Curr Urol Rep. 2025 Jun 23;26(1):52. doi: 10.1007/s11934-025-01280-6.
PURPOSE OF REVIEW
Neurogenic bladder dysfunction (NBD) is a frequent complication of neurological diseases including Parkinson's disease, multiple sclerosis, spinal cord injury, and spina bifida. Managing NBD remains challenging, especially for patients who fail to respond to standard therapies. Sacral neuromodulation (SNM), though FDA-approved for non-neurogenic conditions, is increasingly explored off-label in neurogenic populations.
RECENT FINDINGS
Recent studies demonstrate that SNM can improve lower urinary tract symptoms, bladder storage, and emptying in select NBD patients. Small case series and retrospective reviews suggest reduced catheterization and medication use. Technological advances, such as closed-loop systems and MRI-compatible devices, are broadening SNM's clinical potential. SNM is emerging as a valuable, minimally invasive treatment for neurogenic bladder dysfunction. Careful patient selection and understanding of underlying pathophysiology are essential for success. As evidence grows and device innovations continue, SNM could reshape management strategies for patients with neurogenic bladder.
综述目的
神经源性膀胱功能障碍（NBD）是帕金森病、多发性硬化症、脊髓损伤和脊柱裂等神经系统疾病的常见并发症。管理NBD仍然具有挑战性，尤其是对于那些对标准治疗无反应的患者。骶神经调节（SNM）虽然已获美国食品药品监督管理局（FDA）批准用于非神经源性疾病，但在神经源性人群中越来越多地被用于标签外探索。
最新发现
最近的研究表明，SNM可以改善部分NBD患者的下尿路症状、膀胱储存和排空功能。小型病例系列和回顾性研究表明，导尿和药物使用减少。闭环系统和磁共振成像（MRI）兼容设备等技术进步正在拓宽SNM的临床潜力。SNM正在成为一种有价值的、微创的神经源性膀胱功能障碍治疗方法。仔细的患者选择和对潜在病理生理学的理解是成功的关键。随着证据的增加和设备创新的持续，SNM可能会重塑神经源性膀胱患者的管理策略。
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