Application and progress of neuromodulation in lower urinary tract dysfunction_Journal of Biomedical Engineering

Authors：

WANG Yiming ^1,2 , CHEN Guoqing ^1,2 , YING Xiaoqian ^1,2 ,  LIAO Limin ^1,2

1. Department of Urology of Capital Medical University, Beijing 100069, P.R.China;
2. China Rehabilitation Research Center, Capital Medical University, Beijing 100068, P.R.China;

Corresponding author：

LIAO Limin, Email: lmliao@263.net

Keywords：

neuromodulation; sacral neuromodulation; lower urinary tract dysfunction

DOI：

10.7507/1001-5515.201911078

Video：

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Abstract Full text Figures/Tables Video References Cited by

For those patients with refractory lower urinary tract dysfunction who are not well treated by traditional therapy such as behavior therapy and drug therapy, neuromodulation technologies have gradually become alternative treatments. Several neuromodulation technologies are also used in animal experimental and clinical scientific research by more and more scholars, in order to find more effective methods and mechanisms of treatment of lower urinary tract dysfunction. This article introduces the principle and advantages of common neuromodulation technologies, which focuses on the application in lower urinary tract dysfunction treatment, and analyzes the direction and the broad prospect of neuromodulation.

Citation： WANG Yiming, CHEN Guoqing, YING Xiaoqian, LIAO Limin. Application and progress of neuromodulation in lower urinary tract dysfunction. Journal of Biomedical Engineering, 2020, 37(2): 211-218. doi: 10.7507/1001-5515.201911078 Copy

1.	Elhilali M M, Khaled S M, Kashiwabara T, et al. Sacral neuromodulation: long-term experience of one center. Urology, 2005, 65(6): 1114-1117.
2.	White W M, Mobley J D 3rd, Doggweiler R, et al. Incidence and predictors of complications with sacral neuromodulation. Urology, 2009, 73(4): 731-735.
3.	Al-Zahrani A A, Elzayat E A, Gajewski J B. Long-term outcome and surgical interventions after sacral neuromodulation implant for lower urinary tract symptoms: 14-year experience at 1 center. J Urol, 2011, 185(3): 981-986.
4.	Thompson J H, Sutherland S E, Siegel S W. Sacral neuromodulation: Therapy evolution. Indian J Urol, 2010, 26(3): 379-384.
5.	Spinelli M, Giardiello G, Gerber M, et al. New sacral neuromodulation lead for percutaneous implantation using local anesthesia: Description and first experience. J Urol, 2003, 170(5): 1905-1907.
6.	Hetzer F H, Hahnloser D, Knoblauch Y, et al. New screening technique for sacral nerve stimulation under local anaesthesia. Tech Coloproctol, 2005, 9(1): 25-28.
7.	Scheepens W A, van Koeveringe G A, de Bie R A, et al. Long-term efficacy and safety results of the two-stage implantation technique in sacral neuromodulation. BJU Int, 2002, 90(9): 840-845.
8.	Kessler T M, Madersbacher H, Kiss G. Prolonged sacral neuromodulation testing using permanent leads: a more reliable patient selection method?. Eur Urol, 2005, 47(5): 660-665.
9.	Everaert K, Kerckhaert W, Caluwaerts H, et al. 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, 2004, 45(5): 649-654.
10.	Sievert K D, Matzel K, Ratto C et al. Permanente sakrale Neuromodulation mittels InterStim^®: Ergenisse einer Anwenderbefragung zu aktuellen technischen Entwicklungen. J Urol Urogynäkol, 2007, 14(4): 14-16.
11.	Thon W F, Baskin L S, Jonas U, et al. Surgical principles of sacral foramen electrode implantation. World J Urol, 1991, 9: 133-137.
12.	Kruse M N, Noto H, Roppolo J R, et al. Pontine control of the urinary bladder and external urethral sphincter in the rat. Brain Res, 1990, 532(1/2): 182-190.
13.	Chancellor M B, Chartier-Kastler E J. Principles of sacral nerve stimulation (SNS) for the treatment of bladder and urethral sphincter dysfunctions. Neuromodulation, 2000, 3(1): 16-26.
14.	Elkelini M S, Abuzgaya A, Hassouna M M. Mechanisms of action of sacral neuromodulation. Int Urogynecol J, 2010, 21(Suppl 2): S439-S446.
15.	Blok B, Groen J, Veltman D, et al. Brain plasticity and urge incontinence: PET studies during the first hours of neuromodulation. Neurourol Urodyn, 2003, 22: 490-491.
16.	Gao Yi, Liao Limin, Blok B F. A resting-state functional MRI study on central control of storage: brain response provoked by strong desire to void. Int Urol Nephrol, 2015, 47(6): 927-935.
17.	Jiang Xuewen, Fuller T W, Bandari J, et al. Contribution of GABAA, glycine, and opioid receptors to sacral neuromodulation of bladder overactivity in cats. J Pharmacol Exp Ther, 2016, 359(3): 436-441.
18.	Li Xing, Liao Limin, Chen G, et al. Involvement of opioid receptors in inhibition of bladder overactivity induced by sacral neuromodulation in pigs: A possible action mechanism. Neurourol Urodyn, 2017, 36(7): 1742-1748.
19.	Zirpel L, Su X, Wotton J, et al. AB291. SPR‐18 correlation of sacral nerve lead targeting and urological efficacy: motor mapping, electrode position, and stimulation amplitude. Transl Androl Urol, 2016, 5(Suppl 2): AB291-AB291.
20.	Wang Yiming, Liao Limin, Cong Huiling, et al. Evaluation of sacral neuromodulation system with new six-contact points electrode in pigs. Neurourol Urodyn, 2019, 38(4): 1038-1043.
21.	Blok B, Van Kerrebroeck P, de Wachter S, et al. Three month clinical results with a rechargeable sacral neuromodulation system for the treatment of overactive bladder. Neurourol Urodyn, 2018, 37(S2): S9-S16.
22.	Blok B F, Van Kerrebroeck P, de Wachter S, et al. A prospective, multicenter study of a novel, miniaturized rechargeable sacral neuromodulation system: 12-month results from the RELAX-OAB study. Neurourol Urodyn, 2019, 38(2): 689-695.
23.	Zhang Yaoguang, Zhang Peng, Tian Xiaojun, et al. Remotely programmed sacral neuromodulation for the treatment of patients with refractory overactive bladder: a prospective randomized controlled trial evaluating the safety and efficacy of a novel sacral neuromodulation device. World J Urol, 2019, 37(11): 2481-2492.
24.	顾寅珺, 吕婷婷, 方伟林, 等. 3D 打印技术在骶神经调控术中精准穿刺的应用评估研究. 临床泌尿外科杂志, 2016, 31(12): 1057-1059, 1063.
25.	Ben-Ari A Y, Joshi R, Uskova A, et al. Ultrasound localization of the sacral plexus using a parasacral approach. Anesth Analg, 2009, 108(6): 1977-1980.
26.	Shakuri-Rad J, Cicic A, Thompson J. Prospective randomized study evaluating ultrasound versus fluoroscopy guided sacral InterStim^® Lead placement: A pilot study. Neurourol Urodyn, 2018, 37(5): 1737-1743.
27.	陈琦. 超声引导 S3 骶神经定位装置及定位方法: CN201710520209.4. 2017-11-21.
28.	Li Xing, Liao Limin, Chen G, et al. Effects of acute sacral neuromodulation at different frequencies on bladder overactivity in pigs. Int Neurourol J, 2017, 21(2): 102-108.
29.	MacDiarmid S A, Peters K M, Shobeiri S A, et al. Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder. J Urol, 2010, 183(1): 234-240.
30.	Martinson M, MacDiarmid S, Black E. Cost of neuromodulation therapies for overactive bladder: percutaneous tibial nerve stimulation versus sacral nerve stimulation. J Urol, 2013, 189(1): 210-216.
31.	Elneil S, Digesu A, van Breda H, et al. Safety and performance of a wireless implantable tibial nerve stimulator device for the treatment of patients with overactive bladder. Neurourol Urodynam, 2016, 35(S4): S45-S46.
32.	Blok B F. Sacral neuromodulation for the treatment of urinary bladder dysfunction: mechanism of action and future directions. Bioelectron Med, 2018, 1: 85-94.
33.	Li Xing, Liao Limin, Chen G, et al. Combination of sacral nerve and tibial nerve stimulation for treatment of bladder overactivity in pigs. Int Urol Nephrol, 2017, 49(7): 1139-1145.
34.	Tai Changfeng, Shen Bing, Chen Mang, et al. Suppression of bladder overactivity by activation of somatic afferent nerves in the foot. BJU Int, 2011, 107(2): 303-309.
35.	Chen G, Larson J A, Ogagan P D, et al. Post-stimulation inhibitory effect on reflex bladder activity induced by activation of somatic afferent nerves in the foot. J Urol, 2012, 187(1): 338-343.
36.	Chen M L, Chermansky C J, Shen Bing, et al. Electrical stimulation of somatic afferent nerves in the foot increases bladder capacity in healthy human subjects. J Urol, 2014, 191(4): 1009-1013.
37.	Chen G, Liao L, Miao D. Electrical stimulation of somatic afferent nerves in the foot increases bladder capacity in neurogenic bladder patients after sigmoid cystoplasty. BMC Urol, 2015, 15: 26.
38.	Chen G, Liao Limin, Wang Zhaoxia, et al. Increasing bladder capacity by foot stimulation in rats with spinal cord injuries. BMC Urol, 2017, 17(1): 85.
39.	Hokanson J A, Langdale C L, Sridhar A, et al. Stimulation of the sensory pudendal nerve increases bladder capacity in the rat. Am J Physiol Renal Physiol, 2018, 314(4): F543-F550.
40.	Jiang Haihong, Song Qixiang, Gill B C, et al. Electrical stimulation of the pudendal nerve promotes neuroregeneration and functional recovery from stress urinary incontinence in a rat model. Am J Physiol Renal Physiol, 2018, 315(6): F1555-F1564.
41.	Woock J P, Yoo P B, Grill W M. Activation and inhibition of the micturition reflex by penile afferents in the cat. Am J Physiol Regul Integr Comp Physiol, 2008, 294(6): R1880-R1889.
42.	Gaunt R A, Prochazka A. Transcutaneously coupled, high-frequency electrical stimulation of the pudendal nerve blocks external urethral sphincter contractions. Neurorehabil Neural Repair, 2009, 23(6): 615-626.
43.	Cai Haotian, Morgan T, Pace N, et al. Low pressure voiding induced by a novel implantable pudendal nerve stimulator. Neurourol Urodyn, 2019, 38(5): 1241-1249.
44.	Rijkhoff N J, Wijkstra H, van Kerrebroeck P E, et al. Urinary bladder control by electrical stimulation: review of electrical stimulation techniques in spinal cord injury. Neurourol Urodyn, 1997, 16(1): 39-53.
45.	Brindley G S. The first 500 patients with sacral anterior root stimulator implants: general description. Paraplegia, 1994, 32(12): 795-805.
46.	van Kerrebroeck EV, van der Aa HE, Bosch JL, et al. Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. Part I: Clinical and urodynamic analysis. Dutch Study Group on Sacral Anterior Root Stimulation. Eur Urol, 1997, 31(3): 263-271.
47.	Dahms S E, Hohenfellner M, Thüroff J W. Sacral neurostimulation and neuromodulation in urological practice. Curr Opin Urol, 2000, 10(4): 329-335.
48.	Fischer J, Madersbacher H, Zechberger J, et al. Sacral anterior root stimulation to promote micturition in transverse spinal cord lesions. Zentralbl Neurochir, 1993, 54(2): 77-79.
49.	Ebner A, Jiang C, Lindström S. Intravesical electrical stimulation--an experimental analysis of the mechanism of action. J Urol, 1992, 148(3): 920-924.
50.	Kaplan W E, Richards I. Intravesical bladder stimulation in myelodysplasia. J Urol, 1988, 140(5 Pt 2): 1282-1284.
51.	Deng H, Liao L, Wu J, et al. Clinical efficacy of intravesical electrical stimulation on detrusor underactivity: 8 years of experience from a single center. Medicine (Baltimore), 2017, 96: e8020.
52.	Bruns T M, Weber D J, Gaunt R A. Microstimulation of afferents in the sacral dorsal root ganglia can evoke reflex bladder activity. Neurourol Urodyn, 2015, 34(1): 65-71.
53.	Bremer N, Ruby J, Weyker P D, et al. Neuromodulation: a focus on dorsal root ganglion stimulation. Pain Manag, 2016, 6(3): 205-209.
54.	Liem L. Stimulation of the dorsal root ganglion. Prog Neurol Surg, 2016, 29: 213-224.
55.	Wang Zhaoxia, Liao Limin, Deng Han, et al. The different roles of opioid receptors in the inhibitory effects induced by sacral dorsal root ganglion stimulation on nociceptive and nonnociceptive conditions in cats. Neurourol Urodyn, 2018, 37(8): 2462-2469.
56.	Deer T R, Grigsby E, Weiner R L, et al. A prospective study of dorsal root ganglion stimulation for the relief of chronic pain. Neuromodulation, 2013, 16(1): 67-71; discussion 71-72.
57.	Liem L, Russo M, Huygen F J, et al. A multicenter, prospective trial to assess the safety and performance of the spinal modulation dorsal root ganglion neurostimulator system in the treatment of chronic pain. Neuromodulation, 2013, 16(5): 471-482; discussion 482.

1. Elhilali M M, Khaled S M, Kashiwabara T, et al. Sacral neuromodulation: long-term experience of one center. Urology, 2005, 65(6): 1114-1117.
2. White W M, Mobley J D 3rd, Doggweiler R, et al. Incidence and predictors of complications with sacral neuromodulation. Urology, 2009, 73(4): 731-735.
3. Al-Zahrani A A, Elzayat E A, Gajewski J B. Long-term outcome and surgical interventions after sacral neuromodulation implant for lower urinary tract symptoms: 14-year experience at 1 center. J Urol, 2011, 185(3): 981-986.
4. Thompson J H, Sutherland S E, Siegel S W. Sacral neuromodulation: Therapy evolution. Indian J Urol, 2010, 26(3): 379-384.
5. Spinelli M, Giardiello G, Gerber M, et al. New sacral neuromodulation lead for percutaneous implantation using local anesthesia: Description and first experience. J Urol, 2003, 170(5): 1905-1907.
6. Hetzer F H, Hahnloser D, Knoblauch Y, et al. New screening technique for sacral nerve stimulation under local anaesthesia. Tech Coloproctol, 2005, 9(1): 25-28.
7. Scheepens W A, van Koeveringe G A, de Bie R A, et al. Long-term efficacy and safety results of the two-stage implantation technique in sacral neuromodulation. BJU Int, 2002, 90(9): 840-845.
8. Kessler T M, Madersbacher H, Kiss G. Prolonged sacral neuromodulation testing using permanent leads: a more reliable patient selection method?. Eur Urol, 2005, 47(5): 660-665.
9. Everaert K, Kerckhaert W, Caluwaerts H, et al. 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, 2004, 45(5): 649-654.
10. Sievert K D, Matzel K, Ratto C et al. Permanente sakrale Neuromodulation mittels InterStim^®: Ergenisse einer Anwenderbefragung zu aktuellen technischen Entwicklungen. J Urol Urogynäkol, 2007, 14(4): 14-16.
11. Thon W F, Baskin L S, Jonas U, et al. Surgical principles of sacral foramen electrode implantation. World J Urol, 1991, 9: 133-137.
12. Kruse M N, Noto H, Roppolo J R, et al. Pontine control of the urinary bladder and external urethral sphincter in the rat. Brain Res, 1990, 532(1/2): 182-190.
13. Chancellor M B, Chartier-Kastler E J. Principles of sacral nerve stimulation (SNS) for the treatment of bladder and urethral sphincter dysfunctions. Neuromodulation, 2000, 3(1): 16-26.
14. Elkelini M S, Abuzgaya A, Hassouna M M. Mechanisms of action of sacral neuromodulation. Int Urogynecol J, 2010, 21(Suppl 2): S439-S446.
15. Blok B, Groen J, Veltman D, et al. Brain plasticity and urge incontinence: PET studies during the first hours of neuromodulation. Neurourol Urodyn, 2003, 22: 490-491.
16. Gao Yi, Liao Limin, Blok B F. A resting-state functional MRI study on central control of storage: brain response provoked by strong desire to void. Int Urol Nephrol, 2015, 47(6): 927-935.
17. Jiang Xuewen, Fuller T W, Bandari J, et al. Contribution of GABAA, glycine, and opioid receptors to sacral neuromodulation of bladder overactivity in cats. J Pharmacol Exp Ther, 2016, 359(3): 436-441.
18. Li Xing, Liao Limin, Chen G, et al. Involvement of opioid receptors in inhibition of bladder overactivity induced by sacral neuromodulation in pigs: A possible action mechanism. Neurourol Urodyn, 2017, 36(7): 1742-1748.
19. Zirpel L, Su X, Wotton J, et al. AB291. SPR‐18 correlation of sacral nerve lead targeting and urological efficacy: motor mapping, electrode position, and stimulation amplitude. Transl Androl Urol, 2016, 5(Suppl 2): AB291-AB291.
20. Wang Yiming, Liao Limin, Cong Huiling, et al. Evaluation of sacral neuromodulation system with new six-contact points electrode in pigs. Neurourol Urodyn, 2019, 38(4): 1038-1043.
21. Blok B, Van Kerrebroeck P, de Wachter S, et al. Three month clinical results with a rechargeable sacral neuromodulation system for the treatment of overactive bladder. Neurourol Urodyn, 2018, 37(S2): S9-S16.
22. Blok B F, Van Kerrebroeck P, de Wachter S, et al. A prospective, multicenter study of a novel, miniaturized rechargeable sacral neuromodulation system: 12-month results from the RELAX-OAB study. Neurourol Urodyn, 2019, 38(2): 689-695.
23. Zhang Yaoguang, Zhang Peng, Tian Xiaojun, et al. Remotely programmed sacral neuromodulation for the treatment of patients with refractory overactive bladder: a prospective randomized controlled trial evaluating the safety and efficacy of a novel sacral neuromodulation device. World J Urol, 2019, 37(11): 2481-2492.
24. 顾寅珺, 吕婷婷, 方伟林, 等. 3D 打印技术在骶神经调控术中精准穿刺的应用评估研究. 临床泌尿外科杂志, 2016, 31(12): 1057-1059, 1063.
25. Ben-Ari A Y, Joshi R, Uskova A, et al. Ultrasound localization of the sacral plexus using a parasacral approach. Anesth Analg, 2009, 108(6): 1977-1980.
26. Shakuri-Rad J, Cicic A, Thompson J. Prospective randomized study evaluating ultrasound versus fluoroscopy guided sacral InterStim^® Lead placement: A pilot study. Neurourol Urodyn, 2018, 37(5): 1737-1743.
27. 陈琦. 超声引导 S3 骶神经定位装置及定位方法: CN201710520209.4. 2017-11-21.
28. Li Xing, Liao Limin, Chen G, et al. Effects of acute sacral neuromodulation at different frequencies on bladder overactivity in pigs. Int Neurourol J, 2017, 21(2): 102-108.
29. MacDiarmid S A, Peters K M, Shobeiri S A, et al. Long-term durability of percutaneous tibial nerve stimulation for the treatment of overactive bladder. J Urol, 2010, 183(1): 234-240.
30. Martinson M, MacDiarmid S, Black E. Cost of neuromodulation therapies for overactive bladder: percutaneous tibial nerve stimulation versus sacral nerve stimulation. J Urol, 2013, 189(1): 210-216.
31. Elneil S, Digesu A, van Breda H, et al. Safety and performance of a wireless implantable tibial nerve stimulator device for the treatment of patients with overactive bladder. Neurourol Urodynam, 2016, 35(S4): S45-S46.
32. Blok B F. Sacral neuromodulation for the treatment of urinary bladder dysfunction: mechanism of action and future directions. Bioelectron Med, 2018, 1: 85-94.
33. Li Xing, Liao Limin, Chen G, et al. Combination of sacral nerve and tibial nerve stimulation for treatment of bladder overactivity in pigs. Int Urol Nephrol, 2017, 49(7): 1139-1145.
34. Tai Changfeng, Shen Bing, Chen Mang, et al. Suppression of bladder overactivity by activation of somatic afferent nerves in the foot. BJU Int, 2011, 107(2): 303-309.
35. Chen G, Larson J A, Ogagan P D, et al. Post-stimulation inhibitory effect on reflex bladder activity induced by activation of somatic afferent nerves in the foot. J Urol, 2012, 187(1): 338-343.
36. Chen M L, Chermansky C J, Shen Bing, et al. Electrical stimulation of somatic afferent nerves in the foot increases bladder capacity in healthy human subjects. J Urol, 2014, 191(4): 1009-1013.
37. Chen G, Liao L, Miao D. Electrical stimulation of somatic afferent nerves in the foot increases bladder capacity in neurogenic bladder patients after sigmoid cystoplasty. BMC Urol, 2015, 15: 26.
38. Chen G, Liao Limin, Wang Zhaoxia, et al. Increasing bladder capacity by foot stimulation in rats with spinal cord injuries. BMC Urol, 2017, 17(1): 85.
39. Hokanson J A, Langdale C L, Sridhar A, et al. Stimulation of the sensory pudendal nerve increases bladder capacity in the rat. Am J Physiol Renal Physiol, 2018, 314(4): F543-F550.
40. Jiang Haihong, Song Qixiang, Gill B C, et al. Electrical stimulation of the pudendal nerve promotes neuroregeneration and functional recovery from stress urinary incontinence in a rat model. Am J Physiol Renal Physiol, 2018, 315(6): F1555-F1564.
41. Woock J P, Yoo P B, Grill W M. Activation and inhibition of the micturition reflex by penile afferents in the cat. Am J Physiol Regul Integr Comp Physiol, 2008, 294(6): R1880-R1889.
42. Gaunt R A, Prochazka A. Transcutaneously coupled, high-frequency electrical stimulation of the pudendal nerve blocks external urethral sphincter contractions. Neurorehabil Neural Repair, 2009, 23(6): 615-626.
43. Cai Haotian, Morgan T, Pace N, et al. Low pressure voiding induced by a novel implantable pudendal nerve stimulator. Neurourol Urodyn, 2019, 38(5): 1241-1249.
44. Rijkhoff N J, Wijkstra H, van Kerrebroeck P E, et al. Urinary bladder control by electrical stimulation: review of electrical stimulation techniques in spinal cord injury. Neurourol Urodyn, 1997, 16(1): 39-53.
45. Brindley G S. The first 500 patients with sacral anterior root stimulator implants: general description. Paraplegia, 1994, 32(12): 795-805.
46. van Kerrebroeck EV, van der Aa HE, Bosch JL, et al. Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. Part I: Clinical and urodynamic analysis. Dutch Study Group on Sacral Anterior Root Stimulation. Eur Urol, 1997, 31(3): 263-271.
47. Dahms S E, Hohenfellner M, Thüroff J W. Sacral neurostimulation and neuromodulation in urological practice. Curr Opin Urol, 2000, 10(4): 329-335.
48. Fischer J, Madersbacher H, Zechberger J, et al. Sacral anterior root stimulation to promote micturition in transverse spinal cord lesions. Zentralbl Neurochir, 1993, 54(2): 77-79.
49. Ebner A, Jiang C, Lindström S. Intravesical electrical stimulation--an experimental analysis of the mechanism of action. J Urol, 1992, 148(3): 920-924.
50. Kaplan W E, Richards I. Intravesical bladder stimulation in myelodysplasia. J Urol, 1988, 140(5 Pt 2): 1282-1284.
51. Deng H, Liao L, Wu J, et al. Clinical efficacy of intravesical electrical stimulation on detrusor underactivity: 8 years of experience from a single center. Medicine (Baltimore), 2017, 96: e8020.
52. Bruns T M, Weber D J, Gaunt R A. Microstimulation of afferents in the sacral dorsal root ganglia can evoke reflex bladder activity. Neurourol Urodyn, 2015, 34(1): 65-71.
53. Bremer N, Ruby J, Weyker P D, et al. Neuromodulation: a focus on dorsal root ganglion stimulation. Pain Manag, 2016, 6(3): 205-209.
54. Liem L. Stimulation of the dorsal root ganglion. Prog Neurol Surg, 2016, 29: 213-224.
55. Wang Zhaoxia, Liao Limin, Deng Han, et al. The different roles of opioid receptors in the inhibitory effects induced by sacral dorsal root ganglion stimulation on nociceptive and nonnociceptive conditions in cats. Neurourol Urodyn, 2018, 37(8): 2462-2469.
56. Deer T R, Grigsby E, Weiner R L, et al. A prospective study of dorsal root ganglion stimulation for the relief of chronic pain. Neuromodulation, 2013, 16(1): 67-71; discussion 71-72.
57. Liem L, Russo M, Huygen F J, et al. A multicenter, prospective trial to assess the safety and performance of the spinal modulation dorsal root ganglion neurostimulator system in the treatment of chronic pain. Neuromodulation, 2013, 16(5): 471-482; discussion 482.

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Application and progress of neuromodulation in lower urinary tract dysfunction

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