ISSN: 1305-3876
Hakkında: Özel sayılar şeklinde yayınlanır.
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Sacral Neuromodulation In Urology
Dr. Ali ERGEN,a Dr. Kubilay İNCİa
aÜroloji AD, Hacettepe Üniversitesi Tıp Fakültesi, ANKARA
The first sacral neuromodulation was introduced in 1981. Since then, it has become increasingly popular and an accepted treatment modality for individuals afflicted with lower urinary tract symptoms, such as urinary urge incontinence, urgency frequency, and non-obstructive urinary retention, who fail current standard therapies but the indications for this procedure are still growing. It is a simple, safe and reversible treatment that can be tested beforehand to evaluate if the patient is eligible for it. It bridges the gap between conservative treatment options and surgical procedures.
The cause of failure remains unclear in most cases as it is still unknown exactly how neuromodulation works. At present, there are no clinical variables that can reliably predict the efficacy of neuromodulation in an individual patient. All patients, regardless of indication, must therefore undergo a test stimulation before they can be offered permanent sacral neuromodulation with an implanted system. The latest advance in the sacral neuromodulation involves the use of tined leads. The new tined lead allows fully percutaneous implantation of the kuadripolar permanent lead and offers the possibility of a longer and more reliable screening period than that possible with the PNE test. Depending on the success criteria, average success rates vary from 50 to 70%.
In conclusion, sacral neuromodulation is a valuable technique in the treatments of some patients with severe lower urinary tract symptoms which are refractory to conservative measures.Keywords: Neuromodulation, urgency, incontinence, retention, interstitial cystitisTurkiye Klinikleri J Surg Med Sci 2005, 1(5):61-64
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