Epidural Spinal Cord Stimulation Acutely Modulates Lower Urinary Tract and Bowel Function Following Spinal Cord Injury: A Case Report

This case report explores whether epidural spinal cord stimulation (ESCS) can modulate autonomic circuits involved in lower urinary tract and bowel control after spinal cord injury (SCI). The study presents the case of a 32-year-old man with a chronic motor-complete SCI who was suffering from neurogenic lower urinary tract and bowel dysfunction. The individual's bowel function was assessed using different pre-set configurations and stimulation parameters in a randomized order. Compared to the individual’s conventional bowel management approach, ESCS significantly reduced the time needed for bowel management. Depending on electrode configuration and stimulation parameters, ESCS modulated detrusor pressure and external anal sphincter/pelvic floor muscle tone to various degrees during urodynamic investigation. The data suggest that this neuroprosthetic intervention may provide benefit to lower urinary tract and bowel function in individuals with SCI.

• 1
  ESCS significantly reduced the time needed for bowel management compared to conventional bowel management (p = 0.039).
• 2
  ESCS modulated detrusor pressure and external anal sphincter/pelvic floor muscle tone to various degrees during urodynamic investigation depending on electrode configuration and stimulation parameters.
• 3
  ESCS decreased the severity of neurogenic bowel dysfunction from severe to minor as evidenced by a reduction in NDB Score from 15 to 8, as well as improved the general satisfaction scale from 5 to 8.