Genital nerve stimulation increases bladder capacity after SCI: A meta-analysis

The Journal of Spinal Cord Medicine, 2018 · DOI: 10.1080/10790268.2017.1281372 · Published: July 1, 2018

Simple Explanation

This study explores how electrical stimulation of genital nerves (GNS) can help people with bladder control problems caused by neurological conditions. These problems, like neurogenic detrusor overactivity (NDO), often lead to reduced bladder capacity and incontinence. The researchers analyzed data from multiple studies, including their own, to understand how GNS affects bladder capacity. They looked at factors like the strength of the electrical stimulation and how quickly the bladder was filled during testing. The results showed that GNS generally increases bladder capacity in people with NDO. The increase was consistent across different studies, suggesting GNS could be a useful tool for many individuals with this condition.

Study Duration

Not specified

Participants

97 individuals with neurogenic detrusor overactivity (NDO)

Evidence Level

Meta-analysis of prospective cohort studies

Key Findings

1
Genital nerve stimulation significantly increases bladder capacity in individuals with neurogenic detrusor overactivity.
2
Stimulus amplitude was identified as a significant factor, with increased amplitude leading to greater bladder capacity gains.
3
Increased bladder infusion rate during testing led to increased variability in bladder capacity gain.

Research Summary

This meta-analysis investigated the effect of genital nerve stimulation (GNS) on bladder capacity in individuals with neurogenic detrusor overactivity (NDO). Data from eight studies, including a new cohort, were combined to quantify the effect of GNS and identify factors influencing bladder capacity improvements. The results showed a consistent increase in bladder capacity with GNS across all studies. On average, bladder capacity increased by 131±101 ml with GNS. The number of individuals achieving a bladder capacity greater than 300 ml significantly increased with GNS. Stimulus amplitude was a significant factor predicting bladder capacity gain, while infusion rate affected the variability of the gain. The findings suggest that GNS is a promising tool for managing NDO, warranting further investigation into its chronic effects and clinical applications.

Practical Implications

Clinical Application

GNS could be implemented as a therapeutic approach to reduce neurogenic detrusor overactivity, potentially improving urinary continence and quality of life for individuals with NDO.

Future Research

Further studies should focus on the chronic effects of GNS on bladder control, including clinical measures such as urinary continence and decreased catheterization frequency.

Treatment Optimization

Clinicians should consider adjusting stimulus amplitude to optimize bladder capacity gains in individuals undergoing GNS therapy.

Study Limitations

1
The study primarily focused on acute effects of GNS; long-term efficacy and habituation were not assessed.
2
Study-specific factors may have introduced heterogeneity despite efforts to ensure comparability.
3
The analysis relied on data from existing studies, which may have had variations in methodologies and reporting.

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