A Urodynamic Comparison of Neural Targets for Transcutaneous Electrical Stimulation to Acutely Suppress Detrusor Contractions Following Spinal Cord Injury

Frontiers in Neuroscience, 2019 · DOI: 10.3389/fnins.2019.01360 · Published: December 17, 2019

Simple Explanation

This study explores different locations for applying electrical stimulation through the skin to help control bladder function in people with spinal cord injuries. The goal was to find the best spot to reduce bladder contractions and increase bladder capacity. The researchers tested stimulation of the Dorsal Genital Nerve (DGNS), Tibial Nerve (TNS), Sacral Nerve (SNS), and Spinal Cord (SS) in a group of men with spinal cord injuries to see which method was most effective at improving bladder control. The results showed that stimulating the Dorsal Genital Nerve was the most effective way to reduce bladder contractions and increase bladder capacity in the participants studied.

Study Duration

Not specified

Participants

Seven male participants with supra-sacral SCI

Evidence Level

Not specified

Key Findings

1
Dorsal Genital Nerve Stimulation (DGNS) significantly increased bladder capacity in participants with spinal cord injuries.
2
DGNS, TNS and SNS all increased the volume held following the ﬁrst reﬂex contraction.
3
DGNS only was able to suppress at least one detrusor contraction in ﬁve participants and reduced ﬁrst peak detrusor pressure below 40 cmH2O in these 5.

Research Summary

This study compared the effectiveness of transcutaneous electrical stimulation at four anatomical sites (DGNS, TNS, SNS, SS) in lowering detrusor pressure, reducing incontinence, and increasing bladder capacity in individuals with chronic SCI and NDO. The study found that DGNS was the most effective site for improving storage of urine in the group of people with SCI tested, with meaningful effects on bladder capacity and detrusor pressure in 5/7 participants. The researchers suggest that while TNS, SNS, and SS showed some changes, further exploration is needed to understand their potential and optimize stimulation parameters for future protocols.

Practical Implications

Clinical Management of NDO

DGNS shows promise as a non-invasive treatment option for managing NDO in SCI patients, potentially improving bladder capacity and reducing incontinence.

Future Research Directions

Further research is warranted to optimize stimulation parameters for TNS, SNS, and SS, and to explore their interactions with the neural control of the lower urinary tract.

Personalized Treatment Approaches

The study highlights the potential for personalized treatment approaches based on individual responses to different stimulation sites and parameters.

A Urodynamic Comparison of Neural Targets for Transcutaneous Electrical Stimulation to Acutely Suppress Detrusor Contractions Following Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Clinical Management of NDO

Future Research Directions

Personalized Treatment Approaches

Study Limitations

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A Urodynamic Comparison of Neural Targets for Transcutaneous Electrical Stimulation to Acutely Suppress Detrusor Contractions Following Spinal Cord Injury

Simple Explanation

Key Findings

Research Summary

Practical Implications

Clinical Management of NDO

Future Research Directions

Personalized Treatment Approaches

Study Limitations

Your Feedback

Was this summary helpful?