title: The urodynamic evaluation of neuromodulation in patients with voiding dysfunction.
abstract: OBJECTIVE
  To determine which patients with voiding dysfunction might be suitable for treatment with neuromodulation, using urodynamics to obtain an objective measure of improvement and to illustrate the effect of neuromodulation on voiding dysfunction.
  
  
  METHODS
  Patients were selected for implantation of a neuroprosthesis using a urodynamic evaluation before and during subchronic stimulation; 27 such patients (four men and 23 women, mean age 33 years, SD 15) were evaluated.
  
  
  RESULTS
  Of the 27 patients, the 17 who responded well to neuromodulation all had hypocontractile detrusors and sphincter hypertonicity; sphincter relaxation during micturition was impaired. The urodynamic evaluation showed that these patients were not obstructed. Of 10 patients with spastic pelvic floor syndrome, nine responded well to the treatment. Those not responding to neuromodulation had mainly acontractile detrusors.
  
  
  CONCLUSIONS
  The ideal candidates for neuromodulation are those patients with a spastic pelvic floor syndrome or with a hypocontractile detrusor, in combination with sphincter instability, and impaired sphincter relaxation. An increase of bladder contractility, enhancement of sphincter relaxation and decrease in bladder capacity and residual urine are the most important features of the response.
authors.affiliation: Department of Urology, University of Ghent, Belgium.
authors.forename: K
authors.initials: K
authors.lastname: Everaert
authors.forename: H
authors.initials: H
authors.lastname: Plancke
authors.forename: F
authors.initials: F
authors.lastname: Lefevere
authors.forename: W
authors.initials: W
authors.lastname: Oosterlinck
mesh_terms: D000328:Adult; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008297:Male; D018579:Patient Selection; D010523:Peripheral Nervous System Diseases / Q000503:physiopathology / Q000628:therapy*; D019736:Prostheses and Implants; D012447:Sacrum / Q000294:innervation; D016896:Treatment Outcome; D014554:Urination / Q000502:physiology; D014555:Urination Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D014563:Urodynamics