[Neuromodulation and neurostimulation in urology].
Functional voiding disorders, such as urge incontinence and urine retention, have a high prevalence and often lead to stigmatisation and a diminished quality of life. Patients with idiopathic voiding dysfunctions, for whom conservative treatments are insufficient, can currently be treated with sacral neuromodulation. In sacral neuromodulation a pulse generator is implanted; it is a reversible treatment that can be tested beforehand to evaluate if the patient is eligible for it. After implantation a good result is obtained, on average, in 73% of patients. Patients with spinal cord injury may currently be treated with electrical neurostimulation of the anterior sacral roots, which results in the ability to void without a residue, evacuate stools and obtain an erection or vaginal lubrication. Over 80% of the implanted patients with a spinal cord injury void without residual urine. Furthermore, continence is restored and the bladder capacity increases. In patients with therapy-resistant functional micturition disorders and in patients with spinal cord injury, neuromodulation and neurostimulation must be considered before invasive surgery is carried out.
Scheepens
W A
WA
Academisch Ziekenhuis, afd. Urologie, Postbus 5800, 6202 AZ Maastricht.
van Kerrebroeck
P E
PE
D004599:Electric Stimulation Therapy / Q000379:methods*; D004567:Electrodes, Implanted; D005260:Female; D006801:Humans; D008297:Male; D012447:Sacrum / Q000294:innervation / Q000601:surgery*; D013119:Spinal Cord Injuries / Q000150:complications / Q000628:therapy*; D013126:Spinal Nerve Roots; D016896:Treatment Outcome; D014549:Urinary Incontinence / Q000209:etiology; D016055:Urinary Retention / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology / Q000628:therapy*