Dorsal genital nerve stimulation for the treatment of overactive bladder symptoms.
OBJECTIVE
To evaluate percutaneous placement of electrodes adjacent to the dorsal genital nerve (DGN) and measure the effects of electrical stimulation on symptoms of urge incontinence during 1 week of home use.


METHODS
Prospective, multicenter study. Subjects with urge incontinence underwent percutaneous placement of an electrode using local anesthetic. Test stimulation was applied to confirm electrode placement and cystometry was conducted with and without application of electrical stimulation. A 7-day testing period with the electrode connected to an external pulse generator was performed and was followed by a 3-day post-treatment test period. Bladder diaries, 24 hr pad tests, and adverse event queries were obtained.


RESULTS
Twenty-one women were enrolled with an average age of 52.7 years and average duration of incontinence of 6 years. Percutaneous electrode placement required 5-10 min and was well tolerated. There was no relationship between the acute effects of stimulation on cystometry and the results during home use. Pad weight was reduced by >or= 50% in 13 of 17 subjects (76%) (4 did not complete 24 hr pad testing) and 47% of subjects reported >or=50% reduction in incontinence episodes. Of the subjects who reported severe urgency at baseline, 81% experienced a 50% or greater improvement. Seven subjects experienced nine adverse events ranging from skin irritation to pain and bruising around the electrode exit site.


CONCLUSIONS
Electrodes to stimulate the DGN can be placed percutaneously and a home testing period showed a reduction in overactive bladder symptoms with DGN stimulation.
Goldman
Howard B
HB
The Cleveland Clinic, Section of Voiding Dysfunction and Female Urology, Glickman Urological Institute, Cleveland, Ohio 44195, USA. goldmah@ccf.org
Amundsen
Cindy L
CL
Mangel
Jeffrey
J
Grill
Julie
J
Bennett
Maria
M
Gustafson
Kenneth J
KJ
Grill
Warren M
WM
D041342:Absorbent Pads; D000328:Adult; D000368:Aged; D004567:Electrodes, Implanted; D005240:Feasibility Studies; D005260:Female; D005836:Genitalia, Female / Q000294:innervation*; D006801:Humans; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D004561:Transcutaneous Electric Nerve Stimulation / Q000009:adverse effects; D016896:Treatment Outcome; D014481:United States; D053201:Urinary Bladder, Overactive / Q000503:physiopathology / Q000628:therapy*; D053202:Urinary Incontinence, Urge / Q000503:physiopathology / Q000628:therapy*