Application of Transcranial Magnetic Stimulation in Urological Surgery: From Neuromodulation to Pelvic Floor Functional Reconstruction

Abstract

Benign Prostatic Hyperplasia (BPH) and prostate cancer are common urological diseases in elderly men. Transurethral Resection of the Prostate (TURP) and Laparoscopic Radical Prostatectomy (LRP) are the standard treatments. However, the incidence of Postoperative Transient Urinary Incontinence (POUI) is as high as 30%-49%, with 15% to 20% progressing to persistent urinary incontinence [1]. This complication not only increases healthcare costs, but also severely impacts the quality of life through multiple dimensions, including skin infections, psychological obstacle and social avoidance. Traditional rehabilitation methods have significant limitations. The therapeutic effect of Pelvic Floor Muscle Training (PFMT) relies on patient compliance; biofeedback therapy requires specialized equipment support and has a limited popularity rate; pharmacotherapy is only effective for some symptomatic urinary incontinence; and invasive surgeries carry risks like postoperative avoiding dysfunction. These approaches fail to overcome the challenges of prolonged recovery times and interindividual variability in outcomes [2]. Transcranial Magnetic Stimulation (TMS), as a noninvasive brain stimulation technique, offers a novel strategy for urological functional reconstruction. By modulating the excitability of cortical-spinal-peripheral neural pathway via time-varying magnetic fields, TMS has the advantages of precise targeting, multiparameter regulation, and non-invasive safety. Recent studies demonstrate that TMS combined with conventional therapies significantly shortens urinary incontinence recovery time, improves urodynamic parameters and quality-of-life scores. These findings suggest that TMS is expected to break through the existing treatment paradigm through the regulation of the “central-peripheral” dual pathways and open up a new path for pelvic floor function reconstruction [3].

Keywords:Postoperative Transient Urinary Incontinence (POUI); Transcranial Magnetic Stimulation (TMS); Pelvic Floor Muscle Training (PFMT); Stress; Magnetic fields