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Electrical stimulation for the treatment of lower urinary tract dysfunction after spinal cord injury

机译:电刺激治疗脊髓损伤后下尿路功能障碍

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摘要

Electrical stimulation for bladder control is an alternative to traditional methods of treating neurogenic lower urinary tract dysfunction (NLUTD) resulting from spinal cord injury (SCI). In this review, we systematically discuss the neurophysiology of bladder dysfunction following SCI and the applications of electrical stimulation for bladder control following SCI, spanning from historic clinical approaches to recent pre-clinical studies that offer promising new strategies that may improve the feasibility and success of electrical stimulation therapy in patients with SCI. Electrical stimulation provides a unique opportunity to control bladder function by exploiting neural control mechanisms. Our understanding of the applications and limitations of electrical stimulation for bladder control has improved due to many pre-clinical studies performed in animals and translational clinical studies. Techniques that have emerged as possible opportunities to control bladder function include pudendal nerve stimulation and novel methods of stimulation, such as high frequency nerve block. Further development of novel applications of electrical stimulation will drive progress towards effective therapy for SCI. The optimal solution for restoration of bladder control may encompass a combination of efficient, targeted electrical stimulation, possibly at multiple locations, and pharmacological treatment to enhance symptom control.
机译:用于膀胱控制的电刺激是治疗脊髓损伤(SCI)所致神经源性下尿路功能障碍(NLUTD)的传统方法的替代方法。在这篇综述中,我们系统地讨论了SCI后膀胱功能障碍的神经生理学以及SCI后电刺激在膀胱控制中的应用,从历史性的临床方法到最近的临床前研究均提供了有希望的新策略,这些策略可能会改善SCI的可行性和成功性。 SCI患者的电刺激疗法。电刺激通过利用神经控制机制提供了控制膀胱功能的独特机会。由于对动物进行的许多临床前研究和转化临床研究,我们对电刺激在膀胱控制中的应用和局限性的理解得到了改善。控制膀胱功能的可能机会已出现的技术包括阴部神经刺激和新型刺激方法,例如高频神经阻滞。电刺激的新颖应用的进一步发展将推动向SCI进行有效治疗的进展。恢复膀胱控制的最佳解决方案可能包括有效的,有针对性的电刺激(可能在多个位置)和药理治疗以增强症状控制的组合。

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