Non-invasive antidromic neurostimulation: a simple effective method for improving bladder storage.
Patients with intractably diminished bladder storage function are encountered frequently by neurourologists, occasionally requiring reconstructive surgery for appropriate resolution. Although sacral neuromodulation is a recognized effective therapeutic modality, present techniques are technically demanding, invasive, and expensive. This study investigated the effect of non-invasive third sacral nerve (S3) stimulation on bladder activity during filling cystometry. One hundred forty-six patients underwent standard urodynamic filling cystometry that was then immediately repeated. Patients in the study group (n = 74) received antidromic transcutaneous sacral neurostimulation during the second fill and the control group (n = 72) underwent a second fill without neurostimulation. A statistically significant increase in bladder storage capacity without a corresponding rise in detrusor pressure was observed in the neurostimulated patients. This improvement in functional capacity is an encouraging finding that further supports the use of this non-invasive treatment modality in clinical practice.
Walsh
I K
IK
Department of Urology, University of California, Davis, Sacramento, California, USA.
Thompson
T
T
Loughridge
W G
WG
Johnston
S R
SR
Keane
P F
PF
Stone
A R
AR
D000293:Adolescent; D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D004599:Electric Stimulation Therapy; D005260:Female; D006801:Humans; D008160:Lumbosacral Plexus / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011312:Pressure; D001743:Urinary Bladder / Q000503:physiopathology*; D014549:Urinary Incontinence / Q000503:physiopathology / Q000628:therapy*; D014563:Urodynamics