Potential impact of epidural stimulation on neurogenic bladder function and the value of urodynamic studies throughout usage

This letter responds to feedback regarding a case report on the effects of epidural stimulation. The original report aimed to highlight potential benefits and negative consequences related to epidural stimulation. The authors acknowledge the small sample size of their original study and the absence of a pre-treatment urodynamic study as a baseline. They confirm that both participants received antibiotic treatment for urinary tract infections. The authors suggest that epidural stimulation might alter the tone of pelvic floor muscles, increasing urinary outlet resistance, which could worsen bladder compliance. They advocate for baseline and follow-up urodynamic studies in patients undergoing epidural stimulation.

• 1
  Epidural stimulation can potentially cause significant alterations in detrusor storage pressures, such as worsening compliance associated with increased perineal EMG activity.
• 2
  In one patient, UDS revealed marked detrusor over activity with intermittent detrusor contractions reaching peaks up to 75 cm of H20 and associated with impaired detrusor non-compliance value of 12.5 mL/cm H20.
• 3
  Increased perineal EMG amplitude was observed in conjunction with detrusor overactivity and impaired detrusor non-compliance.