Fu Jing, Li Zhong, Pu Jianlin, Liu YaDong, Mao Qiuyue, Li Chunlan, Li Li, Gai Xuesong
Second Clinical Medical College, Yunnan University of Chinese Medicine, Kunming, 650500, Yunnan, China.
Department of Emergency Trauma Surgery, The First People's Hospital of Yunnan Province, Kunming, 650032, Yunnan, China.
Arch Gynecol Obstet. 2025 Sep 16. doi: 10.1007/s00404-025-08182-5.
Female pelvic floor dysfunctions (PFDs), a global health issue, encompass a range of lower urinary tract and bowel dysfunctions, including urinary incontinence, urinary retention, fecal incontinence, constipation, pelvic pain, and sexual dysfunction. PFDs exhibit high prevalence rates and prolonged recovery periods, resulting in significant economic burdens for patients and healthcare systems. Recently, sacral neuromodulation (SNM) has emerged as a minimally invasive, safe, and effective neuromodulatory intervention, representing a significant advance in the management of refractory PFDs. This technology modulates the sacral nerve reflex pathways through an implanted electrode, enabling simultaneous improvement of multiple PFD symptoms. It is specifically indicated for conditions including overactive bladder, non-obstructive urinary retention, and fecal incontinence, with potential therapeutic benefits extending to chronic pelvic pain, sexual dysfunction, and neurogenic bladder. This paper systematically reviews the underlying mechanisms and technological advancements of SNM, providing a comprehensive analysis of its established applications (overactive bladder, non-obstructive urinary retention, fecal incontinence) and examining emerging uses in other PFD domains. Furthermore, incorporating technological innovations and long-term follow-up data, this paper explores the optimization of indications, safety protocols, and future research avenues for SNM, offering a comprehensive outlook on clinical practice and prospective developments.
女性盆底功能障碍（PFDs）是一个全球性的健康问题，涵盖一系列下尿路和肠道功能障碍，包括尿失禁、尿潴留、大便失禁、便秘、盆腔疼痛和性功能障碍。PFDs的患病率很高，恢复期很长，给患者和医疗系统带来了巨大的经济负担。最近，骶神经调节（SNM）已成为一种微创、安全且有效的神经调节干预手段，代表了难治性PFDs管理方面的重大进展。该技术通过植入电极调节骶神经反射通路，能够同时改善多种PFD症状。它特别适用于膀胱过度活动症、非梗阻性尿潴留和大便失禁等病症，潜在治疗益处还扩展到慢性盆腔疼痛、性功能障碍和神经源性膀胱。本文系统回顾了SNM的潜在机制和技术进展，对其已确立的应用（膀胱过度活动症、非梗阻性尿潴留、大便失禁）进行了全面分析，并探讨了在其他PFD领域的新用途。此外，结合技术创新和长期随访数据，本文探讨了SNM的适应症优化、安全方案和未来研究方向，为临床实践和未来发展提供了全面展望。
