Neuromodulation by surface electrical stimulation of peripheral nerves for reduction of detrusor overactivity in patients with spinal cord injury: A pilot study

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772313Y.0000000175 · Published: January 1, 2015

Simple Explanation

This study explores a non-invasive method to manage bladder dysfunction following spinal cord injury (SCI). The method uses surface electrical stimulation of specific nerves to reduce detrusor overactivity, a condition leading to urinary urgency and incontinence. The researchers applied electrical stimulation to the posterior tibial nerve (PTN) or dorsal penile nerve (DPN) in patients with SCI. They monitored changes in bladder function using voiding diaries and cystometrograms (CMG). The study found some improvement in voiding patterns based on patient diaries, particularly with PTN stimulation. However, the CMG data did not show significant changes. Further research with larger groups is needed to confirm these findings.

Study Duration

Not specified

Participants

15 patients with spinal cord injury

Evidence Level

Pilot Study

Key Findings

1
Voiding chart data showed statistically significant improvement following PTN stimulation.
2
There was a trend of improvement following DPN stimulation, but it was not statistically significant.
3
CMG data were not statistically significant in this sample population.

Research Summary

This pilot study investigated the use of surface electrical stimulation of the posterior tibial nerve (PTN) and dorsal penile nerve (DPN) to reduce detrusor overactivity in patients with spinal cord injury (SCI). The study involved 15 patients and used voiding diaries and cystometrograms (CMG) to assess the effectiveness of the intervention. Voiding diary data showed statistically significant improvement following PTN stimulation and a trend of improvement following DPN stimulation. While voiding diary data showed promise, the CMG data were not statistically significant. The authors suggest further studies with larger sample sizes are needed.

Practical Implications

Potential Non-Invasive Treatment

Surface electrical stimulation offers a potential non-pharmacological and non-invasive treatment option for managing neurogenic bladder in SCI patients.

Further Research Needed

Larger studies are necessary to confirm the efficacy of this treatment and determine the optimal dosage and patient selection criteria.

Home-Based Therapy

The use of surface pad electrodes makes this therapy potentially suitable for home-based use, improving patient convenience and accessibility.

Study Limitations

1
Small sample size limited statistical significance
2
CMG reproducibility can be affected by factors such as urinary tract infections and autonomic dysfunction
3
The study acknowledges that factors contributing to urine production, such as water content in food and perspiration, could not be measured

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