Notice bibliographique
Résumé
While it is true that sacral neuromodulation has only been approved for use in North America since 1997, the concept of sacral stimulation for “curing” voiding dysfunction first took shape almost 50 years ago. After the success of cardiac pacemakers in the 1960s, hopes were high that a number of body functions could be helped with electrical stimulation.1 In the early 1970s, the National Institutes of Health began a comprehensive program involving numerous research centres and research disciplines. The goal was to achieve synergic voiding. Although that did not happen, intermittent voiding was achieved and the dawn of sacral nerve stimulation was upon us.1,2 In 1981, the University of California, San Francisco initiated the first clinical program on sacral neuromodulation (SNM) followed quickly by a large multi-centred trial from 1985 to 1992. In 1997, the Food and Drug Administration (FDA) granted Medtronic approval of the Interstim system for the treatment of urge incontinence in the United States and in 1999 the FDA approved Interstim for the treatment of symptoms of urgency-frequency syndrome and urinary retention. Over the next 13 years, SNM has undergone a tremendous therapeutic evolution. There have been advances in treatment, including a tined lead, the use of fluoroscopic imaging and the smaller implantable pulse generators.3 The indications for SNM have also grown to include interstitial cystitis, chronic pelvic pain, fecal incontinence, constipation and neurogenic bladder.4–8 With these therapeutic changes researchers have searched for less invasive modalities to stimulate these sacral nerves. Posterior tibial nerve stimulation (PTNS) was first described in a small study in 1983 and was shown to inhibit bladder contractions for 2 to 3 days.9 This technology laid dormant until it was revived in the late 2000s when a large randomized double-blind controlled trial demonstrated it to be a safe, effective and viable treatment option for overactive bladder.10 Data for this non-invasive technology continue to accumulate with a multitude of excellent studies published over the last several years.11,12 Elkelini and colleagues describe a rodent model that incorporates a novel transdermal amplitude-modulated signal (TAMS) as a non-invasive alternative to an implantable SNM to treat neurogenic detrusor overactivity.13 The results appear to demonstrate that the amplitude-modulated waveform is sufficient to overcome skin and tissue impedance and stimulate the sacral nerves. The authors demonstrate a decrease in the calcitonin gene-related protein (CGRP) concentration with neurostimulation and significant lowering of the cystometrogram threshold pressure (p = 0.02). Earlier studies using spinal cord injured rodents and SNM revealed a similar finding – lowered CGRP and elimination of bladder hyper-reflexia.14 Unfortunately for the authors, abolishment of uninhibited bladder contractions in their rodent model were not demonstrated. The results are still nonetheless, encouraging. Perhaps, these non-invasive modalities, such as TAMS and PTNS, are the way of the future for treating voiding dysfunction. Many are skeptical that peripheral stimulation of nerves with retrograde migration of signal can actually affect various voiding patterns, despite the accumulation of robust evidence that supports this technology. Of course, these same skeptics likely didn’t believe that we would be removing a prostate with the use of a robot or using lasers to obliterate stones and evaporate prostates. Whether these non-invasive technologies revolutionize the way urologists treat voiding dysfunction remains to be seen. Until then, to quote Charles Kettering: “Our imagination is the only limit to what we can hope to have in the future.”
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,002 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».