{"id":12824,"date":"2025-08-05T09:53:29","date_gmt":"2025-08-05T13:53:29","guid":{"rendered":"https:\/\/www.rigicon.com\/glossary-term\/sacral-neuromodulation\/"},"modified":"2026-10-06T16:21:24","modified_gmt":"2026-10-06T20:21:24","slug":"neuromodulacao-sacral","status":"publish","type":"glossary-term","link":"https:\/\/www.rigicon.com\/pt-br\/glossary-term\/neuromodulacao-sacral\/","title":{"rendered":"Neuromodula\u00e7\u00e3o Sacral"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"featured_media":0,"template":"","glossary-category":[123],"glossary-product":[],"class_list":["post-12824","glossary-term","type-glossary-term","status-publish","hentry","glossary-category-urinary-incontinence-treatments"],"acf":{"gt-definition":"<p>\n        A neuromodula\u00e7\u00e3o sacral (NMS) \u00e9 uma abordagem terap\u00eautica bem estabelecida e minimamente invasiva que envolve o implante de um dispositivo neuroestimulador para fornecer impulsos el\u00e9tricos controlados aos nervos sacrais (normalmente S3-S4).<sup>1<\/sup> <sup>2<\/sup> Essa estimula\u00e7\u00e3o modula de forma eficaz as vias neurais entre o trato urin\u00e1rio inferior, o intestino e o c\u00e9rebro, restaurando a fun\u00e7\u00e3o normal em pacientes com diversos dist\u00farbios urin\u00e1rios e fecais.<sup>3<\/sup> A terapia atua principalmente evocando atividade aferente das ra\u00edzes nervosas sacrais, o que modula o processamento sensorial e o reflexo da mic\u00e7\u00e3o, e n\u00e3o por meio de estimula\u00e7\u00e3o motora direta.<sup>4<\/sup> <sup>5<\/sup> Essa neuromodula\u00e7\u00e3o pode facilitar o esvaziamento vesical ao inibir os reflexos de guarda da mic\u00e7\u00e3o, resultando em redu\u00e7\u00e3o do t\u00f4nus do esf\u00edncter uretral e em contra\u00e7\u00e3o funcional do detrusor nos casos de reten\u00e7\u00e3o, ou ao bloquear a sinaliza\u00e7\u00e3o sensorial ascendente (aferente) anormal nos casos de hiperatividade.<sup>6<\/sup> <sup>7<\/sup>\n    <\/p>","gt-synonyms":"Estimula\u00e7\u00e3o do nervo sacral (SNS), Modula\u00e7\u00e3o do nervo sacral, SNM, SNS, Neuromodulador sacral, Terapia InterStim, Terapia Ax\u00f4nica","gt-citation":"[1] Feloney MP, Stauss K, Leslie SW. Sacral Neuromodulation. StatPearls [Internet]. Last Update: April 18, 2024. DOI: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK567751\/\n\n[2] Thomas L, Hashim H. Sacral neuromodulation for voiding dysfunction and urinary retention. Continence. 2024;11:101337. DOI: https:\/\/doi.org\/10.1016\/j.cont.2024.101337\n\n[3] Spilotros M, Gerbasi S, Lasorsa F, de Rienzo G, Balducci L, Ditonno P, Lucarelli G. Sacral Neuromodulation: Device Improvement and Current Applications in Urology. Medicina. 2024;60(3):509. DOI: https:\/\/doi.org\/10.3390\/medicina60030509\n\n[4] Tanagho EA, Schmidt RA. Electrical stimulation in the clinical management of the neurogenic bladder. J Urol. 1988;140(6):1331-1339. DOI: https:\/\/doi.org\/10.1016\/s0022-5347(17)42038-6. PMID: 3057221\n\n[5] Kavia RB, Dasgupta R, Fowler CJ. Functional imaging and the central control of the bladder. J Comp Neurol. 2005;493(1):27-32. DOI: https:\/\/doi.org\/10.1002\/cne.20753\n\n[6] Chancellor MB, Chartier-Kastler EJ. Principles of sacral nerve stimulation (SNS) for the treatment of bladder and urethral sphincter dysfunctions. Neuromodulation. 2000;3(1):16-26. DOI: https:\/\/doi.org\/10.1046\/j.1525-1403.2000.00015.x. PMID: 22151340\n\n[7] Leng WW, Chancellor MB. How sacral nerve stimulation neuromodulation works. Urol Clin North Am. 2005;32(1):11-18. DOI: https:\/\/doi.org\/10.1016\/j.ucl.2004.09.004. PMID: 15698871","gt-clinical-context":"<p>\n        A neuromodula\u00e7\u00e3o sacral \u00e9 indicada principalmente para pacientes com disfun\u00e7\u00f5es refrat\u00e1rias do trato urin\u00e1rio inferior e do intestino que n\u00e3o responderam adequadamente a tratamentos conservadores ou interven\u00e7\u00f5es farmacol\u00f3gicas.<sup>1<\/sup> <sup>3<\/sup> A terapia recebeu aprova\u00e7\u00e3o da FDA para incontin\u00eancia de urg\u00eancia em 1997 e para urg\u00eancia\/frequ\u00eancia e reten\u00e7\u00e3o urin\u00e1ria n\u00e3o obstrutiva em 1999.<sup>3<\/sup>\n    <\/p>\n    \n    <p>As principais aplica\u00e7\u00f5es cl\u00ednicas incluem:<\/p>\n    \n    <ul>\n        <li><strong>Dist\u00farbios urin\u00e1rios<\/strong>: s\u00edndrome da bexiga hiperativa (com ou sem incontin\u00eancia), urg\u00eancia urin\u00e1ria, frequ\u00eancia e reten\u00e7\u00e3o urin\u00e1ria n\u00e3o obstrutiva.<sup>1<\/sup> <sup>2<\/sup> <sup>3<\/sup> Estudos demonstraram uma taxa de sucesso de 83% para bexiga hiperativa entre os pacientes submetidos ao implante.<sup>1<\/sup><\/li>\n        \n        <li><strong>Dist\u00farbios intestinais<\/strong>: incontin\u00eancia fecal cr\u00f4nica, com aproximadamente 80% dos pacientes apresentando melhora duradoura de pelo menos 50% nos epis\u00f3dios de perda.<sup>1<\/sup><\/li>\n        \n        <li><strong>Condi\u00e7\u00f5es neurog\u00eanicas<\/strong>: eficaz em condi\u00e7\u00f5es de bexiga neurog\u00eanica, como esclerose m\u00faltipla, mielomeningocele e les\u00e3o medular.<sup>1<\/sup><\/li>\n    <\/ul>\n    \n    <p>O procedimento envolve uma abordagem em dois est\u00e1gios:<\/p>\n    <ul>\n        <li>Uma fase inicial de teste, na qual um eletrodo tempor\u00e1rio \u00e9 posicionado para avaliar a resposta terap\u00eautica<\/li>\n        <li>Implante permanente do neuroestimulador se o teste demonstrar melhora significativa dos sintomas (normalmente &gt;50%)<sup>2<\/sup> <sup>3<\/sup><\/li>\n    <\/ul>\n    \n    <p>Os crit\u00e9rios de sele\u00e7\u00e3o de pacientes incluem:<\/p>\n    <ul>\n        <li>Falha dos tratamentos conservadores e farmacol\u00f3gicos<\/li>\n        <li>Aus\u00eancia de obstru\u00e7\u00e3o anat\u00f4mica ou de dist\u00farbio neurol\u00f3gico corrig\u00edvel<\/li>\n        <li>Estabilidade psicol\u00f3gica e capacidade de operar o dispositivo<\/li>\n        <li>Resposta bem-sucedida durante a fase de teste<sup>2<\/sup><\/li>\n    <\/ul>\n    \n    <p>\n        O procedimento de implante \u00e9 realizado sob anestesia local ou geral, com o paciente em dec\u00fabito ventral. O eletrodo quadripolar \u00e9 posicionado por via percut\u00e2nea, sob orienta\u00e7\u00e3o fluorosc\u00f3pica, atrav\u00e9s do terceiro forame sacral, seguindo o trajeto de S3.<sup>3<\/sup> Os dispositivos modernos incluem sistemas recarreg\u00e1veis e op\u00e7\u00f5es compat\u00edveis com resson\u00e2ncia magn\u00e9tica, com dura\u00e7\u00e3o da bateria variando de 5 a 15 anos, dependendo do sistema espec\u00edfico.<sup>3<\/sup>\n    <\/p>","gt-related-evidence":null,"gt-featured":true,"gt-ai-referenced":false,"gt-view-count":136},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v28.7 (Yoast SEO v28.7) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Neuromodula\u00e7\u00e3o Sacral: Tratamento de Disfun\u00e7\u00e3o Vesical | Rigicon<\/title>\n<meta name=\"description\" content=\"Saiba sobre neuromodula\u00e7\u00e3o sacral para bexiga hiperativa, reten\u00e7\u00e3o urin\u00e1ria e incontin\u00eancia fecal. 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