Effects of Genital Nerve Stimulation Amplitude on Bladder Capacity in Spinal Cord Injured Subjects

Evidence-Based Complementary and Alternative Medicine, 2019 · DOI: https://doi.org/10.1155/2019/1248342 · Published: June 24, 2019

Spinal Cord Injury Urology Neurology

Simple Explanation

This study investigated how different levels of genital nerve stimulation (GNS) affect bladder capacity in people with spinal cord injuries (SCI) who have problems with bladder control. GNS involves using electrical stimulation to try and improve bladder function. The researchers used a method called cystometry to measure bladder capacity while applying GNS at different amplitudes, ranging from low to high. They wanted to see if a stronger stimulation would lead to a greater increase in bladder capacity. The study found that there is a relationship between the strength of the GNS and how much the bladder capacity increases. However, very high or very low amplitudes might not follow the same pattern, and more research is needed to understand this better.

Study Duration

Not specified

Participants

8 men with spinal cord injury and neurogenic detrusor overactivity

Evidence Level

Not specified

Key Findings

1
Bladder capacity increased by approximately 34% and 77% of the baseline bladder capacity at 1.5 T and 3.2 T, respectively.
2
A significant positive correlation (R = 0.55, P = 0.01) was found between the stimulation amplitude and bladder capacity.
3
Bladder compliance was significantly increased at 3T and 4T of GNS amplitudes (P < 0.05, LSD HSD).

Research Summary

This study investigated the acute effects of genital nerve stimulation (GNS) amplitude on bladder capacity in individuals with spinal cord injury (SCI) and neurogenic detrusor overactivity (NDO). The findings showed a linear correlation between the stimulation amplitude (ranging from 1 to 4 times the threshold) and bladder capacity gain. The study concludes that GNS effectively increases bladder capacity in subjects with SCI and NDO, contributing to the understanding of GNS amplitude's influence on treating neurogenic detrusor overactivity.

Practical Implications

Optimizing Stimulation Parameters

The findings can help in determining the most effective stimulation amplitudes for clinical research and treatment of neurogenic detrusor overactivity.

Personalized Treatment Approach

The study suggests considering individual factors, such as sensation threshold and tolerance, when setting the stimulation amplitude for GNS therapy.

Future Research Directions

The need for further research to explore the effects of GNS amplitude outside the 1-4T range and to compare continuous versus conditional stimulation.

Study Limitations

1
Limited sample size, preventing further analysis of subject-specific factors contributing to bladder capacity variance.
2
The study did not further analyze subject-specific factors that may have contributed to the variance in bladder capacity outcome, such as patterns of SCI (incomplete or complete), infusion rates, and anticholinergic medications.
3
The actual filling rate in this study was fixed at 30 ml/min in all subjects, which was 2-fold higher than the expected value. The use of a faster infusion rate is a common method of minimizing the length of the experimental session, ensuring subject comfort, and enabling collection of a large amount of data from cystometric measurements.

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