Skip to main content
Erschienen in: Die Urologie 11/2018

11.10.2018 | Überaktive Blase | CME

Sakrale Neuromodulation bei refraktärer überaktiver Blase

verfasst von: Univ.-Prof. Dr. med. Arndt van Ophoven

Erschienen in: Die Urologie | Ausgabe 11/2018

Einloggen, um Zugang zu erhalten

Zusammenfassung

Die sakrale Neuromodulation (SNM) ist eine minimalinvasive, etablierte Behandlungsmethode für die überaktive Blase („overactive bladder“, OAB) und weitere Beckenfunktionsstörungen, wie z. B. nichtobstruktive Retention oder Stuhlinkontinenz. Ein im oberen Gesäßbereich implantierter Schrittmacher gibt schwache elektrische Impulse an die Sakralnerven ab, sodass pathologische afferente Signale der pelvinen Endorgane moduliert werden. Der vorliegende Beitrag vermittelt den aktuellen Kenntnisstand zu Indikationen, Kontraindikationen, Wirkmechanismus, Implantationstechnik, Wirksamkeit und Komplikationen der SNM bei therapierefraktärer OAB.
Literatur
1.
Zurück zum Zitat Tanagho EA, Schmidt RA (1982) Bladder pacemaker: scientific basis and clinical future. Urology 20(6):614–619CrossRef Tanagho EA, Schmidt RA (1982) Bladder pacemaker: scientific basis and clinical future. Urology 20(6):614–619CrossRef
2.
Zurück zum Zitat Matzel KE, Chartier-Kastler E, Knowles CH, Lehur PA, Muñoz-Duyos A, Ratto C et al (2017) Sacral Neuromodulation: standardized electrode placement technique. Neuromodulation 20(8):816–824CrossRef Matzel KE, Chartier-Kastler E, Knowles CH, Lehur PA, Muñoz-Duyos A, Ratto C et al (2017) Sacral Neuromodulation: standardized electrode placement technique. Neuromodulation 20(8):816–824CrossRef
3.
Zurück zum Zitat Siegel S, Noblett K, Mangel J, Bennett J, Griebling TL, Sutherland SE et al (2018) Five-year followup results of a prospective, multicenter study of patients with overactive bladder treated with sacral Neuromodulation. J Urol 199(1):229–236CrossRef Siegel S, Noblett K, Mangel J, Bennett J, Griebling TL, Sutherland SE et al (2018) Five-year followup results of a prospective, multicenter study of patients with overactive bladder treated with sacral Neuromodulation. J Urol 199(1):229–236CrossRef
4.
Zurück zum Zitat Datta SN, Chaliha C, Singh A, Gonzales G, Mishra VC, Kavia RB, Kitchen N, Fowler CJ, Elneil S (2008) Sacral neurostimulation for urinary retention: 10-year experience from one UK centre. BJU Int 101(2):192–196PubMed Datta SN, Chaliha C, Singh A, Gonzales G, Mishra VC, Kavia RB, Kitchen N, Fowler CJ, Elneil S (2008) Sacral neurostimulation for urinary retention: 10-year experience from one UK centre. BJU Int 101(2):192–196PubMed
5.
Zurück zum Zitat Hull T, Giese C, Wexner SD, Mellgren A, Devroede G, Madoff RD et al (2013) Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum 56(2):234–245CrossRef Hull T, Giese C, Wexner SD, Mellgren A, Devroede G, Madoff RD et al (2013) Long-term durability of sacral nerve stimulation therapy for chronic fecal incontinence. Dis Colon Rectum 56(2):234–245CrossRef
6.
Zurück zum Zitat Marcelissen T, Jacobs R, van Kerrebroeck P, de Wachter S (2011) Sacral neuromodulation as a treatment for chronic pelvic pain. J Urol 186(2):387–393CrossRef Marcelissen T, Jacobs R, van Kerrebroeck P, de Wachter S (2011) Sacral neuromodulation as a treatment for chronic pelvic pain. J Urol 186(2):387–393CrossRef
7.
Zurück zum Zitat Maeda Y, Kamm MA, Vaizey CJ, Matzel KE, Johansson C, Rosen H et al (2017) Long-term outcome of sacral neuromodulation for chronic refractory constipation. Tech Coloproctol 21(4):277–286CrossRef Maeda Y, Kamm MA, Vaizey CJ, Matzel KE, Johansson C, Rosen H et al (2017) Long-term outcome of sacral neuromodulation for chronic refractory constipation. Tech Coloproctol 21(4):277–286CrossRef
8.
Zurück zum Zitat Abrams P, Andersson KE, Birder L et al (2009) 4th international consultation on incontinence. Recommendations of the international scientific committee, 4. Aufl. Health Publication Ltd, Paris, France (Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse and Faecal Incontinence) Abrams P, Andersson KE, Birder L et al (2009) 4th international consultation on incontinence. Recommendations of the international scientific committee, 4. Aufl. Health Publication Ltd, Paris, France (Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse and Faecal Incontinence)
9.
Zurück zum Zitat Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S et al (2006) Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 50(6):1306–1314CrossRef Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S et al (2006) Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol 50(6):1306–1314CrossRef
10.
Zurück zum Zitat Irwin DE, Milsom I, Kopp Z, Abrams P, EPIC Study Group (2008) Symptom bother and health care-seeking behavior among individuals with overactive bladder. Eur Urol 53(5):1029–1037CrossRef Irwin DE, Milsom I, Kopp Z, Abrams P, EPIC Study Group (2008) Symptom bother and health care-seeking behavior among individuals with overactive bladder. Eur Urol 53(5):1029–1037CrossRef
11.
Zurück zum Zitat Klotz T, Brüggenjürgen B, Burkart M, Resch A (2007) The economic costs of overactive bladder in Germany. Eur Urol 51(6):1654–1662CrossRef Klotz T, Brüggenjürgen B, Burkart M, Resch A (2007) The economic costs of overactive bladder in Germany. Eur Urol 51(6):1654–1662CrossRef
13.
Zurück zum Zitat Chapple CR, Nazir J, Hakimi Z, Bowditch S, Fatoye F, Guelfucci F et al (2017) Persistence and adherence with Mirabegron versus Antimuscarinic agents in patients with overactive bladder: a retrospective observational study in UK clinical practice. Eur Urol 72(3):389–399CrossRef Chapple CR, Nazir J, Hakimi Z, Bowditch S, Fatoye F, Guelfucci F et al (2017) Persistence and adherence with Mirabegron versus Antimuscarinic agents in patients with overactive bladder: a retrospective observational study in UK clinical practice. Eur Urol 72(3):389–399CrossRef
14.
Zurück zum Zitat Balchandra P, Rogerson L (2014) Women’s perspective: intra-detrusor botox versus sacral neuromodulation for overactive bladder symptoms after unsuccessful anticholinergic treatment. Int Urogynecol J 25(8):1059–1064CrossRef Balchandra P, Rogerson L (2014) Women’s perspective: intra-detrusor botox versus sacral neuromodulation for overactive bladder symptoms after unsuccessful anticholinergic treatment. Int Urogynecol J 25(8):1059–1064CrossRef
15.
Zurück zum Zitat Hashim H, Beusterien K, Bridges JF, Amos K, Cardozo L (2015) Patient preferences for treating refractory overactive bladder in the UK. Int Urol Nephrol 47(10):1619–1627CrossRef Hashim H, Beusterien K, Bridges JF, Amos K, Cardozo L (2015) Patient preferences for treating refractory overactive bladder in the UK. Int Urol Nephrol 47(10):1619–1627CrossRef
16.
Zurück zum Zitat Kessler TM, Maric A, Mordasini L, Wöllner J, Pannek J, Mehnert U et al (2014) Urologists’ referral attitude for sacral neuromodulation for treating refractory idiopathic overactive bladder syndrome: discrete choice experiment. Neurourol Urodyn 33(8):1240–1246CrossRef Kessler TM, Maric A, Mordasini L, Wöllner J, Pannek J, Mehnert U et al (2014) Urologists’ referral attitude for sacral neuromodulation for treating refractory idiopathic overactive bladder syndrome: discrete choice experiment. Neurourol Urodyn 33(8):1240–1246CrossRef
17.
Zurück zum Zitat Fontaine CL, Rudd I, Pakzad M, Hamid R, Ockrim JL, Greenwell TJ (2017) Patient treatment preferences for symptomatic refractory urodynamic idiopathic detrusor overactivity. Urol Ann 9:249–252CrossRef Fontaine CL, Rudd I, Pakzad M, Hamid R, Ockrim JL, Greenwell TJ (2017) Patient treatment preferences for symptomatic refractory urodynamic idiopathic detrusor overactivity. Urol Ann 9:249–252CrossRef
19.
Zurück zum Zitat Jones J, Van de Putte D, De Ridder D, Knowles C, O’Connell R, Nelson D et al (2016) A joint mechanism of action for sacral Neuromodulation for bladder and bowel dysfunction? Urology 97:13–19CrossRef Jones J, Van de Putte D, De Ridder D, Knowles C, O’Connell R, Nelson D et al (2016) A joint mechanism of action for sacral Neuromodulation for bladder and bowel dysfunction? Urology 97:13–19CrossRef
20.
Zurück zum Zitat Malykhina AP, Wyndaele JJ, Andersson KE, De Wachter S, Dmochowski RR (2012) Do the urinary bladder and large bowel interact, in sickness or in health? ICI-RS 2011. Neurourol Urodyn 31(3):352–358CrossRef Malykhina AP, Wyndaele JJ, Andersson KE, De Wachter S, Dmochowski RR (2012) Do the urinary bladder and large bowel interact, in sickness or in health? ICI-RS 2011. Neurourol Urodyn 31(3):352–358CrossRef
21.
Zurück zum Zitat Carrington EV, Knowles CH (2011) The influence of sacral nerve stimulation on anorectal dysfunction. Colorectal Dis 13(Suppl 2):5–9CrossRef Carrington EV, Knowles CH (2011) The influence of sacral nerve stimulation on anorectal dysfunction. Colorectal Dis 13(Suppl 2):5–9CrossRef
22.
Zurück zum Zitat Kessler TM, Fowler CJ (2008) Sacral neuromodulation for urinary retention. Nat Clin Pract Urol 5(12):657–666CrossRef Kessler TM, Fowler CJ (2008) Sacral neuromodulation for urinary retention. Nat Clin Pract Urol 5(12):657–666CrossRef
23.
Zurück zum Zitat Blok BF, Groen J, Bosch JL, Veltman DJ, Lammertsma AA (2006) Different brain effects during chronic and acute sacral neuromodulation in urge incontinent patients with implanted neurostimulators. BJU Int 98(6):1238–1243CrossRef Blok BF, Groen J, Bosch JL, Veltman DJ, Lammertsma AA (2006) Different brain effects during chronic and acute sacral neuromodulation in urge incontinent patients with implanted neurostimulators. BJU Int 98(6):1238–1243CrossRef
24.
Zurück zum Zitat Gourcerol G, Vitton V, Leroi AM, Michot F, Abysique A, Bouvier M (2011) How sacral nerve stimulation works in patients with faecal incontinence. Colorectal Dis 13(8):e203–e211CrossRef Gourcerol G, Vitton V, Leroi AM, Michot F, Abysique A, Bouvier M (2011) How sacral nerve stimulation works in patients with faecal incontinence. Colorectal Dis 13(8):e203–e211CrossRef
25.
Zurück zum Zitat Gillespie JI, van Koeveringe GA, de Wachter SG, de Vente J (2009) On the origins of the sensory output from the bladder: the concept of afferent noise. BJU Int 103(10):1324–1333CrossRef Gillespie JI, van Koeveringe GA, de Wachter SG, de Vente J (2009) On the origins of the sensory output from the bladder: the concept of afferent noise. BJU Int 103(10):1324–1333CrossRef
26.
Zurück zum Zitat Elkelini MS, Abuzgaya A, Hassouna MM (2010) Mechanisms of action of sacral neuromodulation. Int Urogynecol J 21(Suppl 2):439–446CrossRef Elkelini MS, Abuzgaya A, Hassouna MM (2010) Mechanisms of action of sacral neuromodulation. Int Urogynecol J 21(Suppl 2):439–446CrossRef
27.
Zurück zum Zitat Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979CrossRef Melzack R, Wall PD (1965) Pain mechanisms: a new theory. Science 150:971–979CrossRef
28.
Zurück zum Zitat Elneil S (2010) Urinary retention in women and sacral neuromodulation. Int Urogynecol J 21(Suppl 2):475–483CrossRef Elneil S (2010) Urinary retention in women and sacral neuromodulation. Int Urogynecol J 21(Suppl 2):475–483CrossRef
29.
Zurück zum Zitat Spinelli M, Sievert KD (2008) Latest technologic and surgical developments in using InterStim Therapy for sacral neuromodulation: impact on treatment success and safety. Eur Urol 54(6):1287–1296CrossRef Spinelli M, Sievert KD (2008) Latest technologic and surgical developments in using InterStim Therapy for sacral neuromodulation: impact on treatment success and safety. Eur Urol 54(6):1287–1296CrossRef
30.
Zurück zum Zitat Gallas S, Michot F, Faucheron JL, Meurette G, Lehur PA, Barth X et al (2011) Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: results of trial stimulation in 200 patients. Colorectal Dis 13(6):689–696CrossRef Gallas S, Michot F, Faucheron JL, Meurette G, Lehur PA, Barth X et al (2011) Predictive factors for successful sacral nerve stimulation in the treatment of faecal incontinence: results of trial stimulation in 200 patients. Colorectal Dis 13(6):689–696CrossRef
31.
Zurück zum Zitat Ghazwani YQ, Elkelini MS, Hassouna M (2011) Association between stimulation parameters and loss of efficacy of selective sacral nerve root stimulation. Neuromodulation 14(3):266–270CrossRef Ghazwani YQ, Elkelini MS, Hassouna M (2011) Association between stimulation parameters and loss of efficacy of selective sacral nerve root stimulation. Neuromodulation 14(3):266–270CrossRef
32.
Zurück zum Zitat Duelund-Jakobsen J, Laurberg S, Lundby L (2018) The functional outcome of sacral nerve stimulation for faecal incontinence can be improved by using lead model 3889 and a standardized implantation technique. Colorectal Dis 20(6):O152–O157CrossRef Duelund-Jakobsen J, Laurberg S, Lundby L (2018) The functional outcome of sacral nerve stimulation for faecal incontinence can be improved by using lead model 3889 and a standardized implantation technique. Colorectal Dis 20(6):O152–O157CrossRef
33.
Zurück zum Zitat Occhino JA, Siegel SW (2010) Sacral nerve modulation in overactive bladder. Curr Urol Rep 11(5):348–352CrossRef Occhino JA, Siegel SW (2010) Sacral nerve modulation in overactive bladder. Curr Urol Rep 11(5):348–352CrossRef
34.
Zurück zum Zitat Borawski KM, Foster RT, Webster GD, Amundsen CL (2007) Predicting implantation with a neuromodulator using two different test stimulation techniques: a prospective randomized study in urge incontinent women. Neurourol Urodyn 26(1):14–18CrossRef Borawski KM, Foster RT, Webster GD, Amundsen CL (2007) Predicting implantation with a neuromodulator using two different test stimulation techniques: a prospective randomized study in urge incontinent women. Neurourol Urodyn 26(1):14–18CrossRef
35.
Zurück zum Zitat Kessler TM, Madersbacher H, Kiss G (2005) Prolonged sacral neuromodulation testing using permanent leads: a more reliable patient selection method? Eur Urol 47(5):660–665CrossRef Kessler TM, Madersbacher H, Kiss G (2005) Prolonged sacral neuromodulation testing using permanent leads: a more reliable patient selection method? Eur Urol 47(5):660–665CrossRef
36.
Zurück zum Zitat Everaert K, Kerckhaert W, Caluwaerts H, Audenaert M, Vereecke H, De Cuypere G et al (2004) A prospective randomized trial comparing the 1‑stage with the 2‑stage implantation of a pulse generator in patients with pelvic floor dysfunction selected for sacral nerve stimulation. Eur Urol 45(5):649–654CrossRef Everaert K, Kerckhaert W, Caluwaerts H, Audenaert M, Vereecke H, De Cuypere G et al (2004) A prospective randomized trial comparing the 1‑stage with the 2‑stage implantation of a pulse generator in patients with pelvic floor dysfunction selected for sacral nerve stimulation. Eur Urol 45(5):649–654CrossRef
37.
Zurück zum Zitat Cohen BL, Tunuguntla HS, Gousse A (2006) Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol 175(6):2178–2180CrossRef Cohen BL, Tunuguntla HS, Gousse A (2006) Predictors of success for first stage neuromodulation: motor versus sensory response. J Urol 175(6):2178–2180CrossRef
38.
Zurück zum Zitat Bolton JF, Harrison SC (2009) Neuromodulation 10 years on: how widely should we use this technique in bladder dysfunction? Curr Opin Urol 19:375–379CrossRef Bolton JF, Harrison SC (2009) Neuromodulation 10 years on: how widely should we use this technique in bladder dysfunction? Curr Opin Urol 19:375–379CrossRef
39.
Zurück zum Zitat Amend B, Khalil M, Kessler TM, Sievert KD (2011) How does sacral modulation work best? Placement and programming techniques to maximize efficacy. Curr Urol Rep 12(5):327–335CrossRef Amend B, Khalil M, Kessler TM, Sievert KD (2011) How does sacral modulation work best? Placement and programming techniques to maximize efficacy. Curr Urol Rep 12(5):327–335CrossRef
40.
Zurück zum Zitat Schmidt RA, Jonas U, Oleson KA, Janknegt RA, Hassouna MM, Siegel SW et al (1999) Sacral nerve stimulation for treatment of refractory urinary urge incontinence. Sacral Nerve Stimulation Study Group. J Urol 162(2):352–357CrossRef Schmidt RA, Jonas U, Oleson KA, Janknegt RA, Hassouna MM, Siegel SW et al (1999) Sacral nerve stimulation for treatment of refractory urinary urge incontinence. Sacral Nerve Stimulation Study Group. J Urol 162(2):352–357CrossRef
41.
Zurück zum Zitat Weil EH, Ruiz-Cerdá JL, Eerdmans PH, Janknegt RA, Bemelmans BL, van Kerrebroeck PE (2000) Sacral root neuromodulation in the treatment of refractory urinary urge incontinence: a prospective randomized clinical trial. Eur Urol 37(2):161–171CrossRef Weil EH, Ruiz-Cerdá JL, Eerdmans PH, Janknegt RA, Bemelmans BL, van Kerrebroeck PE (2000) Sacral root neuromodulation in the treatment of refractory urinary urge incontinence: a prospective randomized clinical trial. Eur Urol 37(2):161–171CrossRef
42.
Zurück zum Zitat Hassouna MM, Siegel SW, Nÿeholt AA, Elhilali MM, van Kerrebroeck PE, Das AK, Gajewski JB, Janknegt RA, Rivas DA, Dijkema H, Milam DF, Oleson KA, Schmidt RA (2000) Sacral neuromodulation in the treatment of urgency-frequency symptoms: a multicenter study on efficacy and safety. J Urol 163(6):1849–1854CrossRef Hassouna MM, Siegel SW, Nÿeholt AA, Elhilali MM, van Kerrebroeck PE, Das AK, Gajewski JB, Janknegt RA, Rivas DA, Dijkema H, Milam DF, Oleson KA, Schmidt RA (2000) Sacral neuromodulation in the treatment of urgency-frequency symptoms: a multicenter study on efficacy and safety. J Urol 163(6):1849–1854CrossRef
43.
Zurück zum Zitat Groenendijk PM, Lycklama à Nyeholt AA, Heesakkers JP, van Kerrebroeck PE, Hassouna MM, Gajewski JB et al (2008) Urodynamic evaluation of sacral neuromodulation for urge urinary incontinence. BJU Int 101(3):325–329CrossRef Groenendijk PM, Lycklama à Nyeholt AA, Heesakkers JP, van Kerrebroeck PE, Hassouna MM, Gajewski JB et al (2008) Urodynamic evaluation of sacral neuromodulation for urge urinary incontinence. BJU Int 101(3):325–329CrossRef
44.
Zurück zum Zitat Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET et al (2015) Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6‑months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn 34(3):224–230CrossRef Siegel S, Noblett K, Mangel J, Griebling TL, Sutherland SE, Bird ET et al (2015) Results of a prospective, randomized, multicenter study evaluating sacral neuromodulation with InterStim therapy compared to standard medical therapy at 6‑months in subjects with mild symptoms of overactive bladder. Neurourol Urodyn 34(3):224–230CrossRef
45.
Zurück zum Zitat Amundsen CL, Richter HE, Menefee SA, Komesu YM, Arya LA, Gregory WT et al (2016) OnabotulinumtoxinA vs sacral Neuromodulation on refractory urgency urinary incontinence in women: a randomized clinical trial. JAMA 316(13):1366–1374CrossRef Amundsen CL, Richter HE, Menefee SA, Komesu YM, Arya LA, Gregory WT et al (2016) OnabotulinumtoxinA vs sacral Neuromodulation on refractory urgency urinary incontinence in women: a randomized clinical trial. JAMA 316(13):1366–1374CrossRef
46.
Zurück zum Zitat Amundsen CL, Komesu YM, Chermansky C, Gregory WT, Myers DL, Honeycutt EF et al (2018) Two-year outcomes of sacral Neuromodulation versus OnabotulinumtoxinA for refractory urgency urinary incontinence: a randomized trial. Eur Urol 74(1):66–73CrossRef Amundsen CL, Komesu YM, Chermansky C, Gregory WT, Myers DL, Honeycutt EF et al (2018) Two-year outcomes of sacral Neuromodulation versus OnabotulinumtoxinA for refractory urgency urinary incontinence: a randomized trial. Eur Urol 74(1):66–73CrossRef
47.
Zurück zum Zitat Kraus SR (2017) Sacral Neuromodulation is preferred over OnabotulinumtoxinA injection for overactive bladder in women: pro. J Urol 198(3):501–502CrossRef Kraus SR (2017) Sacral Neuromodulation is preferred over OnabotulinumtoxinA injection for overactive bladder in women: pro. J Urol 198(3):501–502CrossRef
48.
Zurück zum Zitat Oerlemans DJ, van Kerrebroeck PE (2008) Sacral nerve stimulation for neuromodulation of the lower urinary tract. Neurourol Urodyn 27(1):28–33CrossRef Oerlemans DJ, van Kerrebroeck PE (2008) Sacral nerve stimulation for neuromodulation of the lower urinary tract. Neurourol Urodyn 27(1):28–33CrossRef
49.
Zurück zum Zitat van Voskuilen AC, Oerlemans DJ, Weil EH, de Bie RA, van Kerrebroeck PE (2006) Long term results of neuromodulation by sacral nerve stimulation for lower urinary tract symptoms: a retrospective single center study. Eur Urol 49(2):366–372CrossRef van Voskuilen AC, Oerlemans DJ, Weil EH, de Bie RA, van Kerrebroeck PE (2006) Long term results of neuromodulation by sacral nerve stimulation for lower urinary tract symptoms: a retrospective single center study. Eur Urol 49(2):366–372CrossRef
50.
Zurück zum Zitat Burks FN, Diokno AC, Lajiness MJ, Ibrahim IA, Peters KM (2008) Sacral neuromodulation reprogramming: is it an office burden? Int Urogynecol J Pelvic Floor Dysfunct 19(8):1137–1140CrossRef Burks FN, Diokno AC, Lajiness MJ, Ibrahim IA, Peters KM (2008) Sacral neuromodulation reprogramming: is it an office burden? Int Urogynecol J Pelvic Floor Dysfunct 19(8):1137–1140CrossRef
51.
Zurück zum Zitat Noblett K, Siegel S, Mangel J, Griebling TL, Sutherland SE, Bird ET et al (2016) Results of a prospective, multicenter study evaluating quality of life, safety, and efficacy of sacral neuromodulation at twelve months in subjects with symptoms of overactive bladder. Neurourol Urodyn 35(2):246–251CrossRef Noblett K, Siegel S, Mangel J, Griebling TL, Sutherland SE, Bird ET et al (2016) Results of a prospective, multicenter study evaluating quality of life, safety, and efficacy of sacral neuromodulation at twelve months in subjects with symptoms of overactive bladder. Neurourol Urodyn 35(2):246–251CrossRef
52.
Zurück zum Zitat Al-zahrani AA, Elzayat EA, Gajewski JB (2011) Long-term outcome and surgical interventions after sacral neuromodulation implant for lower urinary tract symptoms: 14-year experience at 1 center. J Urol 185(3):981–986CrossRef Al-zahrani AA, Elzayat EA, Gajewski JB (2011) Long-term outcome and surgical interventions after sacral neuromodulation implant for lower urinary tract symptoms: 14-year experience at 1 center. J Urol 185(3):981–986CrossRef
53.
Zurück zum Zitat Peters KM, Killinger KA, Gilleran JP, Bartley J, Wolfert C, Boura JA (2017) Predictors of reoperation after sacral neuromodulation: a single institution evaluation of over 400 patients. Neurourol Urodyn 36(2):354–359CrossRef Peters KM, Killinger KA, Gilleran JP, Bartley J, Wolfert C, Boura JA (2017) Predictors of reoperation after sacral neuromodulation: a single institution evaluation of over 400 patients. Neurourol Urodyn 36(2):354–359CrossRef
Metadaten
Titel
Sakrale Neuromodulation bei refraktärer überaktiver Blase
verfasst von
Univ.-Prof. Dr. med. Arndt van Ophoven
Publikationsdatum
11.10.2018
Verlag
Springer Medizin
Erschienen in
Die Urologie / Ausgabe 11/2018
Print ISSN: 2731-7064
Elektronische ISSN: 2731-7072
DOI
https://doi.org/10.1007/s00120-018-0777-1

Weitere Artikel der Ausgabe 11/2018

Die Urologie 11/2018 Zur Ausgabe

Einführung zum Thema

Immuntherapie

Mitteilungen der DGU

Mitteilungen der DGU

AUO

AUO

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

Stufenschema weist Prostatakarzinom zuverlässig nach

22.04.2024 Prostatakarzinom Nachrichten

Erst PSA-Test, dann Kallikrein-Score, schließlich MRT und Biopsie – ein vierstufiges Screening-Schema kann die Zahl der unnötigen Prostatabiopsien erheblich reduzieren: Die Hälfte der Männer, die in einer finnischen Studie eine Biopsie benötigten, hatte einen hochgradigen Tumor.

Harnwegsinfektprophylaxe: Es geht auch ohne Antibiotika

20.04.2024 EAU 2024 Kongressbericht

Beim chronischen Harnwegsinfekt bei Frauen wird bisher meist eine Antibiotikaprophylaxe eingesetzt. Angesichts der zunehmenden Antibiotikaresistenz erweist sich das Antiseptikum Methenamin-Hippurat als vielversprechende Alternative, so die Auswertung einer randomisierten kontrollierten Studie.

Update Urologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.