[Sacral neuromodulation in treatment of functional disorders of the lower urinary tract. An overview of basic principles, indications, outcomes].
Over the last few years, sacral neuromodulation has become an established treatment option for dysfunctions of the lower urinary tract. It fills the gap that used to exist between conservative therapy and costly invasive methods such as urinary drainage via a deactivated bowel segment. Initially, the clinical value of sacral neuromodulation was controversial even among neurourologists. This was mainly due to a lack of understanding of the physiological processes, uncertain diagnostics, the design of the hardware, and a surgical topography relatively unknown to the urologist. In the meantime, however, sacral neuromodulation has become a standard part of clinical routine with respect to the treatment of dysfunctions of the lower urinary tract, and it is regularly employed in various urological institutions across Europe and the USA. This form of treatment, which is the final straw for patients who believed themselves-after many frustrated therapy attempts-to be "hopeless cases," can now also successfully be employed as an ambulatory measure. The latest data from our hospital, as well as contributions presented at the last DGU Congress in Wiesbaden, indicate that patients with neurogenic urinary retention are the most likely to profit from this treatment option.
Bannowsky
A
A
Klinik für Urologie, Christian-Albrechts-Universität, Kiel. abannowsky@urology.uni-kiel.de
Seif
C
C
Sugimoto
S
S
Böhler
G
G
van der Horst
C
C
Bross
S
S
Alken
P
P
Jünemann
K-P
KP
Braun
P M
PM
D004599:Electric Stimulation Therapy; D004567:Electrodes, Implanted; D007172:Erectile Dysfunction / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D010275:Parasympathetic Nervous System / Q000503:physiopathology; D010413:Penis / Q000294:innervation*; D012447:Sacrum; D013126:Spinal Nerve Roots / Q000503:physiopathology*; D013564:Sympathetic Nervous System / Q000503:physiopathology; D001743:Urinary Bladder / Q000294:innervation; D014563:Urodynamics / Q000502:physiology