title: A urodynamic study of surface neuromodulation versus sham in detrusor instability and sensory urgency.
abstract: OBJECTIVE
  We studied the effect of surface neuromodulation on cystometric pressure and volume parameters in women with detrusor instability or sensory urgency. Electrical current was delivered to the suprapubic region and third sacral foramina via a transcutaneous electrical nerve stimulator with sham neuromodulation control.
  
  
  METHODS
  A consecutive series of women with proved detrusor instability or sensory urgency were randomized to 3 surface neuromodulation groups. Volume and pressure parameters were the main outcomes of transcutaneous electrical nerve stimulation applied during second cystometric fill.
  
  
  RESULTS
  Sham transcutaneous electrical nerve stimulation did not alter the outcome measures. However, neuromodulation delivered across the suprapubic and sacral skin effected a reduction in mean maximum height of detrusor contraction. A current which inhibits motor activity was not superior to that which inhibits sensory perception in reducing detrusor pressure. Response in sensory urgency was poor.
  
  
  CONCLUSIONS
  Results from our sham controlled study suggest that short-term surface neuromodulation via transcutaneous electrical nerve stimulation may have a role in the treatment of detrusor instability. Future studies must examine the clinical effect of long-term surface neuromodulation.
authors.affiliation: Western Sydney Continence Management Service Pennant Hills, Department of Obstetrics and Gynaecology, University of New South Wales, Australia.
authors.forename: W F
authors.initials: WF
authors.lastname: Bower
authors.forename: K H
authors.initials: KH
authors.lastname: Moore
authors.forename: R D
authors.initials: RD
authors.lastname: Adams
authors.forename: R
authors.initials: R
authors.lastname: Shepherd
mesh_terms: D000328:Adult; D000368:Aged; D004558:Electric Stimulation; D005260:Female; D006801:Humans; D008875:Middle Aged; D009130:Muscle, Smooth / Q000503:physiopathology; D018377:Neurotransmitter Agents / Q000502:physiology; D001743:Urinary Bladder / Q000503:physiopathology; D014549:Urinary Incontinence / Q000503:physiopathology*; D014563:Urodynamics
chemical_list: D018377:Neurotransmitter Agents