Ambulatory urodynamic monitoring assessment of dorsal genital nerve stimulation for suppression of involuntary detrusor contractions following spinal cord injury: a pilot study

Spinal cord injury (SCI) can disrupt the neural control of the lower urinary tract (LUT), leading to neurogenic detrusor overactivity (NDO). This condition is characterized by involuntary detrusor contractions, often at low volumes, causing high detrusor pressures, feelings of urgency, urinary incontinence, and incomplete emptying. Dorsal genital nerve stimulation (DGNS) has shown promise in suppressing involuntary detrusor contractions and increasing bladder capacity. DGNS appears to work by activating the urethral sphincter and bladder neck, alongside inhibition of parasympathetic pathways and excitation of detrusor-inhibiting sympathetic pathways. This study aimed to trial on-demand, continuous or intermittent DGNS protocols, selected as appropriate for individual people with SCI depending on residual bladder sensation, using AUM to assess the effect on bladder pressure and capacity.

• 1
  Bladder capacity was increased from 244 ± 59 to 346 ± 61 ml (p = 0.0078), a mean change of 46 ± 25%.
• 2
  Maximum detrusor pressure was decreased from 58 ± 18 to 47 ± 18 cmH2O (p = 0.0156), a change of 17 ± 13%, and average peak detrusor pressure was decreased from 56 ± 16 to 31 ± 128 cmH2O (p = 0.0156), a mean reduction of 50 ± 19%.
• 3
  There was an increase in the number of detrusor contractions from the first involuntary detrusor contraction to a strong desire, urgency or incontinence, from 1.5 ± 1.4 to 4.3 ± 1.7, and an increase in time of 23 ± 22 min.