[Neuromodulation as a treatment for overactive bladder syndrome].
Neuromodulation is used as a treatment for overactive bladder syndrome, if conservative management is ineffective or only partially effective. Sacral neuromodulation is now a minimally invasive treatment as a result of improvements in surgical technique, and it has good long-term results. Nevertheless the risk of complications such as pain and decreasing effect is still present. Developments in alternative neuromodulation treatments, such as posterior tibial nerve stimulation, pudendal nerve stimulation and intravesical injection therapy with botulinum neurotoxin, have extended the role of neuromodulation. Intravesical injection therapy with botulinum toxin, along with sacral neuromodulation, has been included in the treatment algorithm of overactive bladder syndrome if this does not respond to conservative therapy. When choosing for a neuromodulation therapy, the side-effects and complications of the treatments should be considered alongside the specific patient situation and evidence for effectiveness and long-term effectiveness.
Maastricht Universitair Medisch Centrum, afd. Urologie, Maastricht, the Netherlands. martijn.smits@mumc.nl
Martijn A C
MA
Smits
Tom A T
TA
Marcelissen
Philip E V
PE
van Kerrebroeck
Stefan G G
SG
de Wachter
D000283:Administration, Intravesical; D019274:Botulinum Toxins, Type A / Q000008:administration & dosage / Q000627:therapeutic use*; D004599:Electric Stimulation Therapy / Q000009:adverse effects; D006801:Humans; D008160:Lumbosacral Plexus; D009465:Neuromuscular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D013577:Syndrome; D016896:Treatment Outcome; D053201:Urinary Bladder, Overactive / Q000188:drug therapy / Q000628:therapy*
D009465:Neuromuscular Agents; D019274:Botulinum Toxins, Type A