We reviewed the literature on transcutaneous electrical nerve stimulation(TENS)used as a therapy for overactive bladder(OAB)symptoms,with a particular focus on:stimulation site,stimuli parameters,neural structures tho...We reviewed the literature on transcutaneous electrical nerve stimulation(TENS)used as a therapy for overactive bladder(OAB)symptoms,with a particular focus on:stimulation site,stimuli parameters,neural structures thought to be targeted,and the clinical and urodynamic outcomes achieved.The majority of studies used sacral or tibial nerve stimulation.The literature suggests that,whilst TENS therapy may have neuromodulation effects,patient are unlikely to benefit to a significant extent from a single application of TENS and indeed clear benefits from acute studies have not been reported.In long-term studies there were differences in the descriptions of stimulation intensity,strategy of the therapy,and positioning of the electrodes,as well as in the various symptoms and pathology of the patients.Additionally,most studies were uncontrolled and hence did not evaluate the placebo effect.Little is known about the underlying mechanism by which these therapies work and therefore exactly which structures need to be stimulated,and with what parameters.There is promising evidence for the efficacy of a transcutaneous stimulation approach,but adequate standardisation of stimulation criteria and outcome measures will be necessary to define the best way to administer this therapy and document its efficacy.展开更多
Sacral neuromodulation(SNM)therapy has revolutionized the management of many forms of anal incontinence,with an expanded use and a medium-term efficacy of 75%overall.This review discusses the technique of SNM therapy,...Sacral neuromodulation(SNM)therapy has revolutionized the management of many forms of anal incontinence,with an expanded use and a medium-term efficacy of 75%overall.This review discusses the technique of SNM therapy,along with its complications and troubleshooting and a discussion of the early data pertaining to peripheral posterior tibial nerve stimulation in incontinent patients.Future work needs to define the predictive factors for neurostimulatory success,along with the likely mechanisms of action of their therapeutic action.展开更多
Urinary incontinence markedly affects women’s quality of life. There are several methods to mitigate or reduce this problem such as medication, surgery, or exercises. Of various types of urinary incontinence, overact...Urinary incontinence markedly affects women’s quality of life. There are several methods to mitigate or reduce this problem such as medication, surgery, or exercises. Of various types of urinary incontinence, overactive bladder consists of one category, which is often resistant to various treatments. Electrical stimulation methods have been considered a treatment option of overactive bladder. We here briefly summarize various treatment options for urinary incontinence, with special reference to the role of electrical stimulation methods for this disease. Electrical stimulation methods include vaginal electrical stimulation (VES), posterior tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS). The three methods have shown good results, and these findings will contribute to achieving a better quality of life for patients.展开更多
Inflammatory bowel disease(IBD)is an inflammatory disease of the gastrointestinal(GI)tract.It has financial and quality of life impact on patients.Although there has been a significant advancement in treatments,a cons...Inflammatory bowel disease(IBD)is an inflammatory disease of the gastrointestinal(GI)tract.It has financial and quality of life impact on patients.Although there has been a significant advancement in treatments,a considerable number of patients do not respond to it or have severe side effects.Therapeutic approaches such as electrical neuromodulation are being investigated to provide alternate options.Although bioelectric neuromodulation technology has evolved significantly in the last decade,sacral nerve stimulation(SNS)for fecal incontinence remains the only neuromodulation protocol commonly utilized use for GI disease.For IBD treatment,several electrical neuromodulation techniques have been studied,such as vagus NS,SNS,and tibial NS.Several animal and clinical experiments were conducted to study the effectiveness,with encouraging results.The precise underlying mechanisms of action for electrical neuromodulation are unclear,but this modality appears to be promising.Randomized control trials are required to investigate the efficacy of intrinsic processes.In this review,we will discuss the electrical modulation therapy for the IBD and the data pertaining to it.展开更多
基金funded by the European Commission’s Research and Innovation Framework programme(Marie Curie Actions Initial Training Network)for the TRUST project(Training Urology Scientists to Develop Treatments)Grant Number 238541The study formed part of the project portfolio of the NIHR Devices for Dignity Healthcare Technology Cooperative.
文摘We reviewed the literature on transcutaneous electrical nerve stimulation(TENS)used as a therapy for overactive bladder(OAB)symptoms,with a particular focus on:stimulation site,stimuli parameters,neural structures thought to be targeted,and the clinical and urodynamic outcomes achieved.The majority of studies used sacral or tibial nerve stimulation.The literature suggests that,whilst TENS therapy may have neuromodulation effects,patient are unlikely to benefit to a significant extent from a single application of TENS and indeed clear benefits from acute studies have not been reported.In long-term studies there were differences in the descriptions of stimulation intensity,strategy of the therapy,and positioning of the electrodes,as well as in the various symptoms and pathology of the patients.Additionally,most studies were uncontrolled and hence did not evaluate the placebo effect.Little is known about the underlying mechanism by which these therapies work and therefore exactly which structures need to be stimulated,and with what parameters.There is promising evidence for the efficacy of a transcutaneous stimulation approach,but adequate standardisation of stimulation criteria and outcome measures will be necessary to define the best way to administer this therapy and document its efficacy.
文摘Sacral neuromodulation(SNM)therapy has revolutionized the management of many forms of anal incontinence,with an expanded use and a medium-term efficacy of 75%overall.This review discusses the technique of SNM therapy,along with its complications and troubleshooting and a discussion of the early data pertaining to peripheral posterior tibial nerve stimulation in incontinent patients.Future work needs to define the predictive factors for neurostimulatory success,along with the likely mechanisms of action of their therapeutic action.
文摘Urinary incontinence markedly affects women’s quality of life. There are several methods to mitigate or reduce this problem such as medication, surgery, or exercises. Of various types of urinary incontinence, overactive bladder consists of one category, which is often resistant to various treatments. Electrical stimulation methods have been considered a treatment option of overactive bladder. We here briefly summarize various treatment options for urinary incontinence, with special reference to the role of electrical stimulation methods for this disease. Electrical stimulation methods include vaginal electrical stimulation (VES), posterior tibial nerve stimulation (PTNS) and sacral nerve stimulation (SNS). The three methods have shown good results, and these findings will contribute to achieving a better quality of life for patients.
文摘Inflammatory bowel disease(IBD)is an inflammatory disease of the gastrointestinal(GI)tract.It has financial and quality of life impact on patients.Although there has been a significant advancement in treatments,a considerable number of patients do not respond to it or have severe side effects.Therapeutic approaches such as electrical neuromodulation are being investigated to provide alternate options.Although bioelectric neuromodulation technology has evolved significantly in the last decade,sacral nerve stimulation(SNS)for fecal incontinence remains the only neuromodulation protocol commonly utilized use for GI disease.For IBD treatment,several electrical neuromodulation techniques have been studied,such as vagus NS,SNS,and tibial NS.Several animal and clinical experiments were conducted to study the effectiveness,with encouraging results.The precise underlying mechanisms of action for electrical neuromodulation are unclear,but this modality appears to be promising.Randomized control trials are required to investigate the efficacy of intrinsic processes.In this review,we will discuss the electrical modulation therapy for the IBD and the data pertaining to it.
