Neuromodulation最新文献

{"title":"Long-term Outcomes of Sacral Nerve Stimulation on the Treatment of Fecal Incontinence: A Systematic Review","authors":"Erica Eggers MD ,&nbsp;Tess Crouss MD ,&nbsp;Jasjit Beausang MD ,&nbsp;Devon Smith DO ,&nbsp;Sean Spector MD ,&nbsp;Benjamin Saracco MLS, MAIT ,&nbsp;Amanda Adams MLS ,&nbsp;Taylor Dickinson MD ,&nbsp;Lioudmila Lipetskaia MD","doi":"10.1016/j.neurom.2024.06.504","DOIUrl":"10.1016/j.neurom.2024.06.504","url":null,"abstract":"<div><h3>Introduction</h3><div>Sacral nerve stimulation (SNS) has now been used as a treatment for fecal incontinence (FI) for &gt;20 years. The aim of this systematic review was to determine the long-term efficacy of SNS on the treatment of FI.</div></div><div><h3>Materials and Methods</h3><div>A comprehensive search of the MEDLINE, Embase, and Cochrane Central data bases was performed to find publications, excluding case reports, reporting outcomes of SNS treatment for FI in adults with ≥36 months of follow-up. Bias was assessed using the Risk of Bias in Non-randomized Studies–of Interventions tool. Data were summarized per reported FI-related outcomes for symptom severity and quality of life.</div></div><div><h3>Results</h3><div>In total, 3326 publications were identified, and 36 studies containing 3770 subjects were included. All studies had a serious risk of bias. Success was variably defined by each publication and ranged from 59.4% to 87.5% for per-protocol analyses and 20.9% to 87.5% for intention-to-treat analyses. All studies reporting bowel diary data, St Mark’s scores, and Cleveland Clinic Incontinence Scores indicated significant improvement with SNS treatment in the long term. Studies that evaluated quality-of-life outcomes also all showed improvements in quality of life as measured by the Fecal Incontinence Quality of Life Scale. The aggregate revision rate was 35.2%, and the explantation rate was 19.7%.</div></div><div><h3>Conclusions</h3><div>Improvements in objective and subjective outcomes at ≥36 months support using SNS for the long-term treatment of FI. Interpretation of these data is limited by a lack of comparative trials and heterogeneity of the included studies.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 715-726"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141996216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electroacupuncture at ST36 Relieves Visceral Hypersensitivity Based on the Vagus-Adrenal Axis in the Remission Stage of Ulcerative Colitis","authors":"Mingwei Fan MBBS ,&nbsp;Tan Chen MBBS ,&nbsp;Jinlan Tian MBBS ,&nbsp;Can Zhang MA ,&nbsp;Zijian Zhao MBBS ,&nbsp;Xinru Liu MBBS ,&nbsp;Shuhui Zhang MA ,&nbsp;Yan Chen PhD","doi":"10.1016/j.neurom.2024.12.006","DOIUrl":"10.1016/j.neurom.2024.12.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Although electroacupuncture (EA) at ST36 has been shown to alleviate visceral hypersensitivity in rats with ulcerative colitis (UC), the exact mechanism remains unknown. This study aims to investigate whether EA can effectively inhibit the activity of enteric glial cells (EGCs) through the adrenergic antiinflammatory pathway and thereby attenuate visceral hypersensitivity in rats with UC in remission.</div></div><div><h3>Materials and Methods</h3><div>Sprague-Dawley rats were continuously fed 5% dextran sulfate sodium (DSS) for seven days to establish intestinal inflammation. After seven days of remission, rats underwent EA (<em>n</em> = 6, 100 Hz, 1 mA, one hour) or sham EA (<em>n</em> = 6) for 14 days. A normal control group (<em>n</em> = 6) received no treatment. Inflammation was assessed using disease activity index (DAI) inflammatory cytokines. Visceral sensitivity was examined weekly by abdominal withdrawal reflexes (AWR) score. We used the enzyme-linked immunosorbent assay method to measure levels of norepinephrine (NE) in serum after EA. The expression of EGCs, levels of inflammatory cytokine S100 calcium-binding protein β (S100β), and associated pathway proteins receptor for advanced glycosylation end-products (RAGE), myeloid differentiation factor 88 (MyD88), and nuclear factor-κ B (NF-κB) in the colon were assessed using immunofluorescence staining and Western blotting.</div></div><div><h3>Results</h3><div>The Model group exhibited elevated DAI scores, shortened colon, and increased inflammatory cytokines; the EA group showed significant relief of symptoms. The Model group exhibited elevated visceral hypersensitivity, which resolved after 14 days of EA treatment. The EA group exhibited higher NE levels than did the Model group. Compared with the Model group, the expression of EGCs in the colonic submucosa was reduced in the EA group, and the expression of S100β, RAGE, MyD88, and NF-κB proteins were downregulated.</div></div><div><h3>Conclusion</h3><div>This study suggests that EA potentially reduces visceral hypersensitivity in UC by decreasing the activity of EGCs and the release of S100β through noradrenergic pathway.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 812-824"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 Calendar of Events - June","authors":"","doi":"10.1016/S1094-7159(25)00201-6","DOIUrl":"10.1016/S1094-7159(25)00201-6","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Page 873"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A First-In-Human Feasibility Study of a New Implantable Tibial Nerve Stimulator for Overactive Bladder Syndrome","authors":"Parminder S. Sethi MD ,&nbsp;Kenneth M. Peters MD","doi":"10.1016/j.neurom.2025.01.013","DOIUrl":"10.1016/j.neurom.2025.01.013","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to evaluate the preliminary feasibility and safety of a new implantable tibial nerve stimulator device in patients with overactive bladder (OAB).</div></div><div><h3>Materials and Methods</h3><div>Ten patients with OAB in whom conservative treatments had failed participated in the study. All patients received daily stimulation therapy for two weeks and weekly stimulation therapy for 13 weeks, at the lowest electrical output amplitude at which paresthesia or motor response occurred. OAB symptoms (three-day bladder diary), quality-of-life scores (OAB-questionnaire Short Form), and patient global response (GRA) were assessed at each follow-up visit.</div></div><div><h3>Results</h3><div>Among the patients enrolled (mean age 68 years), seven were OAB-wet and three OAB-dry. After 13 weeks of therapy delivery, a reduction in the number of daily voids during waking hours (8.5 ± 2.5 to 6.3 ± 1.9; <em>p</em> = 0.016), incontinence episodes (2.5 ± 1.8 to 0.3 ± 0.5; <em>p &lt;</em> 0.001), and the daily voids associated with urgency (7.6 ± 3.1 to 3.0 ± 3.1; <em>p &lt;</em> 0.001) was reported. Eight of the ten subjects were classified as responders for ≥one OAB component, with one patient reporting worsened symptoms of urgency (+6%). All ten patients reported global improvement in symptoms on the GRA with a median score of 6. Improvements in OAB severity and health-related quality-of-life scores were noted from pre- to posttreatment across participants (<em>p &lt;</em> 0.001). No serious adverse effects were noted.</div></div><div><h3>Conclusion</h3><div>This first-in-human pilot study allowed for capture of preliminary safety and effectiveness information on a new implantable tibial nerve stimulator device in the population of interest to adequately power a larger, pivotal randomized study.</div></div><div><h3>Clinical Trial Registration</h3><div>The <span><span>Clinicaltrials.gov</span><svg><path></path></svg></span> registration number for the study is NCT04115228.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 832-839"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect and Mechanism of Vagal Nerve Stimulation on Gastric Motility: A Preliminary Rodent Study","authors":"Shiying Li MBBS, MS ,&nbsp;Feng Ye MD, PhD ,&nbsp;Sujuan Zhang MD, PhD ,&nbsp;Yi Liu MD, PhD ,&nbsp;Jiande D.Z. Chen PhD","doi":"10.1016/j.neurom.2024.12.005","DOIUrl":"10.1016/j.neurom.2024.12.005","url":null,"abstract":"<div><h3>Background</h3><div>Patients with functional dyspepsia often exhibit gastrointestinal motor disorders associated with gastric myoelectrical dysrhythmia. This study investigated the effects of vagal nerve stimulation (VNS) in a rodent model of gastric slow-wave dysrhythmia induced by colorectal distention (CRD).</div></div><div><h3>Materials and Methods</h3><div>Male Sprague-Dawley rats were implanted with wires in the gastric body to record gastric slow waves and in the left cervical vagal nerve for stimulation. VNS was conducted over six sessions to optimize its efficacy on CRD-induced gastric dysrhythmia: control, CRD, and CRD with four different sets of parameters varying in frequency and stimulation on/off times. Both the CRD and VNS were conducted throughout the recording after the meal. Atropine was administered in two additional sessions, with or without VNS, to explore the involvement of the cholinergic pathway. The percentage of postprandial normal gastric slow waves (NSW), defined as the percentage of time during which the gastric slow wave was normal, was quantified using adaptive spectral analysis.</div></div><div><h3>Results</h3><div>The study findings were 1) CRD significantly reduced the percentage of NSW from 89.2% ± 1.6% to 64.3% ± 3.5% (<em>p</em> &lt; 0.001), which was mitigated by VNS at 14 Hz (83.5% ± 3.0%, <em>p</em> &lt; 0.001) and 25 Hz (88.4% ± 1.7%, <em>p</em> &lt; 0.001); 2) atropine slightly, but not significantly, decreased the percentage of NSW to 54.1% ± 3.2% and abolished the beneficial effects of VNS at 25 Hz on gastric slow waves (60.9% ± 3.3%, <em>p</em> &lt; 0.01); and 3) CRD delayed gastric emptying, which was restored by 25 Hz VNS.</div></div><div><h3>Conclusion</h3><div>VNS using optimal parameters effectively ameliorated CRD-induced gastric dysmotility mediated through the vagal-cholinergic pathway, suggesting that VNS may hold therapeutic potential for functional gastrointestinal disorders.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 767-774"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143365059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Deep Analysis of the Pelvic Floor Motor Response in Sacral Neuromodulation Linking It to Outcome","authors":"Sam Tilborghs MD ,&nbsp;Sigrid Van de Borne MD ,&nbsp;Donald Vaganée MD ,&nbsp;Erik Fransen PhD ,&nbsp;Stefan De Wachter MD, PhD","doi":"10.1016/j.neurom.2024.09.477","DOIUrl":"10.1016/j.neurom.2024.09.477","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to characterize the pelvic floor muscles (PFM) motor response provoked during sacral neuromodulation (SNM) programming, determining its utility in improving therapy delivery.</div></div><div><h3>Materials and Methods</h3><div>This prospective study (January 2018–September 2021) included patients with overactive bladder (OAB) or nonobstructive urinary retention (NOUR) who underwent unilateral SNM. An external pulse generator was connected for three weeks. Success was defined as ≥50% improvement. Sensory threshold (ST), motor threshold (MT), and their ratio (MT-ST) were analyzed. PFM electromyography was recorded using a multiple array probe. A linear regression model with ST, MT, MT-ST, and mean natural log transformation (peak-to peak-amplitude) vs outcome (percentage improvement) was performed. Differences in electrical PFM motor response amplitude between different electrical stimulation levels (ST ± 0.5 mA) and different parts (four sides, three depths) of the pelvic floor were modeled using linear mixed model analysis (LMM).</div></div><div><h3>Results</h3><div>The study population comprised 64 women (overall success 80%). Responders presented with significantly lower MT and MT-ST (unpaired <em>t</em>-test: <em>p</em> = 0.0271 and <em>p</em> = 0.0158, respectively). MT and MT-ST proved a significant relationship with percentage improvement (linear regression [lin. Regr.] <em>p</em> = 0.0304, R² = 0.0745 and lin. Regr. <em>p</em> = 0.0107, R² = 0.1020, respectively). PFM amplitude showed a significant relationship with percentage improvement for all stimulation amplitudes (ST ± 0.5 mA) (lin. Regr. <em>p</em> &lt; 0.0001, R² = 0.2560), and subsensory stimulation intensities (lin. Regr. <em>p</em> = 0.0008, R² = 0.1673). Responders presented with a different evolution in increase in overall peak-to-peak amplitude over increased stimulation intensities (LMM: <em>p</em> = 0.0160), presenting with a significantly higher slope. This was significantly different depending on the percentage improvement for all the different sides and depths, with contralateral superior being the only exception (LMM: <em>p</em> = 0.0071, range: 0.0663–&lt;0.0001).</div></div><div><h3>Conclusions</h3><div>A clear correlation was found between therapy efficacy and PFM motor response elicited by unilateral sacral spinal nerve stimulation, linking lead placement and SNM outcome. Responders presented with lower MTs, lower MT-STs, higher compound muscle action potentials, and higher continuous activation of their PFM at subsensory stimulation levels than did nonresponders.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 787-795"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710499","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Electrical Diuretics: Lateral Epidural Stimulation of Dorsal Roots to Increase Diuresis","authors":"Pawel Chodakowski MD ,&nbsp;Adam Sokal MD, PhD ,&nbsp;Alicja Bogusz MS ,&nbsp;Agnieszka Manka MS ,&nbsp;Piotr Bogus MS ,&nbsp;Mike Eggen PhD ,&nbsp;Lilian Kornet PhD","doi":"10.1016/j.neurom.2024.11.005","DOIUrl":"10.1016/j.neurom.2024.11.005","url":null,"abstract":"<div><h3>Background</h3><div>Stimulating diuresis is crucial in heart failure (HF) treatment. Diuretic resistance develops in approximately 30% to 45% of patients with HF.</div></div><div><h3>Objective</h3><div>We investigated the feasibility and safety of lateral epidural stimulation (LES) to enhance diuresis by stimulating renal afferent sensory nerves.</div></div><div><h3>Materials and Methods</h3><div>In 16 pigs, volume overload with elevated and stable pressures was induced. Diuresis was measured during cycles of up to two hours, and glomerular filtration rate (GFR) was assessed in 12 of 16 experiments. The most effective vertebrae stimulation level was established first. T11–T12 stimulation effectiveness was tested, using a high current (1.2 mA) in one animal and relatively low currents (0.1–0.3 mA) in 15 animals. In three animals, LES effects were assessed during furosemide infusion.</div></div><div><h3>Results</h3><div>T11–T12 was the most effective vertebrae level for LES. Diuresis increased from 18 mL/20 min (SD = 4 mL/20 min) to 47 mL/20 min (SD = 32 mL/20 min) (<em>n</em> = 9, <em>p</em> &lt; 0.0001), and GFR increased on average 44 [mL/min] (SD = 26, <em>n</em> = 6) (<em>p</em> &lt; 0.001) during T11–T12 LES compared with baseline, excluding one experiment with high current and three lead misplacements. Negative effects in these excluded cases were, according to necroscopy, related to ventral root stimulation, causing shivering, muscle contractions, and elevated heart rate. LES enhanced diuresis during a continuous infusion of furosemide by 54% and 149% and GFR increased by 16 and 14 [mL/min] (two/three correct lead placement).</div></div><div><h3>Conclusion</h3><div>LES at T11–T12 could rival the effectiveness of long-term HF diuretics. Unlike furosemide, LES positively affected kidney function.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 803-811"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for Readers","authors":"","doi":"10.1016/S1094-7159(25)00206-5","DOIUrl":"10.1016/S1094-7159(25)00206-5","url":null,"abstract":"","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Page A3"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dorsal Root Ganglion Stimulation for Chronic Pelvic Pain Secondary to Endometriosis","authors":"Tiago da Silva Freitas MD, PhD ,&nbsp;Antonio Jorge Barbosa de Oliveira MD ,&nbsp;Stanley Golovac MD ,&nbsp;Bernardo Assumpcao de Monaco MD, PhD","doi":"10.1016/j.neurom.2024.11.007","DOIUrl":"10.1016/j.neurom.2024.11.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic pelvic pain (CPP) is a multifaceted condition that poses significant challenges in clinical management owing to its complex and varied pathophysiology, including neuropathic, somatic, visceral, and musculoskeletal components. Endometriosis is frequently associated with CPP, necessitating a comprehensive, multimodal treatment strategy. This approach typically includes physical and behavioral therapy, pharmacologic interventions, surgical management of endometriosis, and various pain-modulating procedures. Neuromodulation, particularly spinal cord stimulation (SCS), has been used in refractory cases; however, its use is often met with limited success and a notable rate of explants. This case series presents nine patients with intractable CPP secondary to endometriosis, unresponsive to conventional treatments, who were treated with dorsal root ganglion stimulation (DRG-S).</div></div><div><h3>Materials and Methods</h3><div>Between 2022 and 2023, ten patients with severe CPP secondary to endometriosis, unresponsive to various multimodal treatments—including previous interventional pain procedures, gynecologic surgery, and in some cases, SCS—were recruited for this prospective study. Of these, nine patients underwent permanent DRG-S, with bilateral L1 and S2 DRG-S leads placed (four leads per patient). Patients were assessed for pain intensity using the visual analog scale (VAS), narcotic consumption, and quality of life (QoL) using the 12-item short-form (SF-12) survey, with a 12-month follow-up period. Nonparametric statistical analyses were conducted using SPSS.</div></div><div><h3>Results</h3><div>One patient was excluded from the study owing to a lack of pain relief during the DRG-S trial. The remaining nine patients underwent permanent bilateral L1 and S2 DRG-S placement. Significant improvement in pain scores was observed and sustained throughout the follow-up period (VAS 9 ± 1.5–2 ± 2.0; <em>p</em> = 0.003), along with a marked reduction in opioid consumption, with four patients becoming completely free of narcotics (<em>p</em> = 0.046). SF-12 physical scores improved by 60.2 ± 7.8 (<em>p</em> = 0.006), and SF-12 mental scores improved by 45.9 ± 2.76 (<em>p</em> = 0.01).</div></div><div><h3>Conclusion</h3><div>Bilateral L1 and S2 DRG-S yielded robust and sustained outcomes, including significant improvements in pain scores, reduced narcotic consumption, and enhanced QoL over a 12-month follow-up period.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 825-831"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Meta-Analysis on the Efficacy and Safety of Sacral Neuromodulation for Neurogenic Bladder or Bowel Dysfunction","authors":"Penghao Sun MD,&nbsp;Wei Song PhD","doi":"10.1016/j.neurom.2024.11.004","DOIUrl":"10.1016/j.neurom.2024.11.004","url":null,"abstract":"<div><h3>Background</h3><div>The aim of this work was to evaluate the efficacy and safety of sacral neuromodulation (SNM) in the treatment of neurogenic bladder (NB) and neurogenic bowel dysfunction (NBD).</div></div><div><h3>Materials and Methods</h3><div>A systematic literature search was conducted using PubMed and Web of Science up to August 2024, focusing on studies related to SNM treatment for NB or NBD. After assessing the quality of the studies, data were extracted and analyzed using Review Manager 5.3 (Cochrane Collaboration, Oxford, UK).</div></div><div><h3>Results</h3><div>A total of 15 studies involving 573 patients were included. After SNM treatment, the patients showed significant improvements in key outcome measures, including voiding frequency per 24 hours (weighted mean difference [WMD] −4.08; 95% CI −6.80, −1.35; <em>p =</em> 0.003), single voiding volume (WMD 123.60; 95% CI 93.17, 154.03; <em>p</em> &lt; 0.001), number of leakage episodes per 24 hours (WMD −4.27; 95% CI −5.79, −2.74; <em>p</em> &lt; 0.001), number of nocturia (WMD −2.48; 95% CI −2.62, −2.35; <em>p</em> &lt; 0.001), clean intermittent self-catheterization per 24 hours (WMD −2.35; 95% CI −2.98, −1.71; <em>p</em> &lt; 0.001), bladder compliance (WMD 9.09; 95% CI 2.31, 15.87; <em>p</em> = 0.009), maximum detrusor pressure during storage phase (WMD −14.76; 95% CI −18.63, −10.88; <em>p</em> &lt; 0.001), maximum urine flow rate (WMD 6.50; 95% CI 4.21, 8.80; <em>p</em> &lt; 0.001), maximum bladder capacity (WMD 66.28; 95% CI 2.83, 129.73; <em>p</em> = 0.04), Wexner score (WMD −9.98; 95% CI −13.65, −6.31; <em>p</em> &lt; 0.001), and NBD score (WMD −6.31; 95% CI −6.89, −5.73; <em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>These results indicated that SNM was effective and safe in treating NB or NBD.</div></div>","PeriodicalId":19152,"journal":{"name":"Neuromodulation","volume":"28 5","pages":"Pages 727-736"},"PeriodicalIF":3.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786235","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}