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TREATMENT OF NEUROGENIC DETRUSOR OVERACTIVITY IN SPINAL CORD INJURED PATIENTS BY CONDITIONAL ELECTRICAL STIMULATION

2005; Lippincott Williams & Wilkins; Volume: 173; Issue: 6 Linguagem: Inglês

10.1097/01.ju.0000158160.11083.1b

1527-3792

John Hansen, S. Media, M. Nøhr, Fin Biering‐Sørensen, Thomas Sinkjær, Nico Rijkhoff,

Urological Disorders and Treatments

No AccessJournal of UrologyAdult Urology: Voiding Dysfunction1 Jun 2005TREATMENT OF NEUROGENIC DETRUSOR OVERACTIVITY IN SPINAL CORD INJURED PATIENTS BY CONDITIONAL ELECTRICAL STIMULATION J. HANSEN, S. MEDIA, M. NØHR, F. BIERING-SØRENSEN, T. SINKJÆR, and N.J. M. RIJKHOFF J. HANSENJ. HANSEN , S. MEDIAS. MEDIA , M. NØHRM. NØHR , F. BIERING-SØRENSENF. BIERING-SØRENSEN , T. SINKJÆRT. SINKJÆR , and N.J. M. RIJKHOFFN.J. M. RIJKHOFF View All Author Informationhttps://doi.org/10.1097/01.ju.0000158160.11083.1bAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The feasibility of automatic event driven electrical stimulation of the dorsal penile/clitoral nerve in the treatment of neurogenic detrusor overactivity (NDO) was evaluated in individuals with spinal cord injury. Materials and Methods: The study included 2 women and 14 men older than 18 years with NDO, bladder capacity below 500 ml and complete or incomplete suprasacral spinal cord injury. Detrusor pressure (Pdet) was recorded during ordinary, natural bladder filling. In a similar subsequent recording Pdet was used to trigger electrical stimulation when pressure exceeded 10 cm H2O. Results: Of the 16 patients enrolled in this study 13 had increased bladder capacity together with a storage pressure decrease as a result of automatic, event driven electrical stimulation. In 2 patients stimulation could not inhibit the first undesired contraction, leakage occurred and finally 1 could not tolerate stimulation. During stimulated filling Pdet never exceeded 55 cm H2O. Thus, storage pressure was sufficiently low to prevent kidney damage. An average bladder capacity increase of 53% was achieved. Conclusions: This study demonstrates the feasibility of automatic, event driven electrical stimulation in the treatment of NDO. Although the setup in this experiment is not suitable in a clinical setting, the treatment modality is promising and it warrants further investigation. References 1 : Clinical significance of detrusor sphincter dyssynergia type in patients with post-traumatic spinal cord injury. Urology2000; 56: 565. Google Scholar 2 : Association of level of injury and bladder behavior in patients with post-traumatic spinal cord injury. Urology2000; 55: 490. Google Scholar 3 : The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology2003; 61: 37. Google Scholar 4 : Tamsulosin: efficacy and safety in patients with neurogenic lower urinary tract dysfunction due to suprasacral spinal cord injury. J Urol2003; 170: 1242. 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Google Scholar Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University (JH, TS, NJMR) and Department of Urology, Aalborg Hospital (MN), Aalborg, Spinal Cord Unit, Rheumatological Department, Viborg Hospital (SM), Viborg and Clinic for Spinal Cord Injuries, NeuroScience Centre, Rigshospitalet, Copenhagen University Hospital (FB-S), Copenhagen, Denmark© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byWein A (2019) Re: Conditional Neuromodulation of Neurogenic Detrusor Overactivity Using Transrectal Stimulation in Patients with Spinal Cord Injury: A Proof of Principle StudyJournal of Urology, VOL. 201, NO. 5, (863-863), Online publication date: 1-May-2019.Martens F, Heesakkers J and Rijkhoff N (2011) Surgical Access for Electrical Stimulation of the Pudendal and Dorsal Genital Nerves in the Overactive Bladder: A ReviewJournal of Urology, VOL. 186, NO. 3, (798-804), Online publication date: 1-Sep-2011.Yoo P, Horvath E, Amundsen C, Webster G and Grill W (2010) Multiple Pudendal Sensory Pathways Reflexly Modulate Bladder and Urethral Activity in Patients With Spinal Cord InjuryJournal of Urology, VOL. 185, NO. 2, (737-743), Online publication date: 1-Feb-2011.Opisso E, Borau A, Rodríguez A, Hansen J and Rijkhoff N (2008) Patient Controlled Versus Automatic Stimulation of Pudendal Nerve Afferents to Treat Neurogenic Detrusor OveractivityJournal of Urology, VOL. 180, NO. 4, (1403-1408), Online publication date: 1-Oct-2008. Volume 173Issue 6June 2005Page: 2035-2039 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsbladderurinary incontinencebladder, neurogenicelectric stimulationspinal cord injuriesMetricsAuthor Information J. HANSEN More articles by this author S. MEDIA More articles by this author M. NØHR More articles by this author F. BIERING-SØRENSEN More articles by this author T. SINKJÆR More articles by this author N.J. M. RIJKHOFF More articles by this author Expand All Advertisement PDF downloadLoading ...