title: Intravesical electrostimulation versus sacral neuromodulation for incomplete spinal cord patients suffering from neurogenic non-obstructive urinary retention.
abstract: OBJECTIVE
  To compare the efficacy of intravesical electrostimulation (IVES) versus sacral neuromodulation (SNM) in patients with incomplete spinal cord lesions (SCL) and neurogenic non-obstructive urinary retention (N-NOR).
  
  
  METHODS
  In this retrospective study, 77 N-NOR patients underwent IVES (minimum 28 sessions), then after returning to voiding baseline symptoms, percutaneous first stage of SNM (lasting for minimum 4 weeks). After the two neuromodulation treatments, responders were categorized as patients experiencing both a 50% reduction of volume per catheterization per ml and a 50% reduction in number of catheterizations per day when comparing the 7-day voiding diaries at the end of both procedures to baselines. New urodynamics were performed subsequently. Responders to first stage of SNM underwent permanent SNM.
  
  
  RESULTS
  Forty-eight patients responded to neither of the treatments, whereas 29 responded to both IVES and first-stage SNM. No significant statistical differences (P>0.05) were detected in the voiding diaries. Following the two procedures, the first sensation of bladder filling was either maintained or recovered by all responders, whereas the same 11 patients reached a bladder contractility index of >100. The 29 IVES responders lost their clinical benefits in a mean follow-up of 9.6 months. Only 10 out of the 29 patients became nonresponsive to permanent SNM, in a mean follow-up of 54 months.
  
  
  CONCLUSIONS
  A strict correlation in terms of clinical and urodynamic patterns was demonstrated in patients with incomplete SCL and N-NOR, following IVES and first stage of SNM. However, voiding improvement through IVES was short-term when compared with the effects of permanent SNM.
authors.affiliation: Neuro-urology Department Florence, Spinal Unit, Spinal Unit Florence, Florence, Italy. giuseppelombard63@libero.it
authors.forename: G
authors.initials: G
authors.lastname: Lombardi
authors.forename: S
authors.initials: S
authors.lastname: Musco
authors.forename: M
authors.initials: M
authors.lastname: Celso
authors.forename: A
authors.initials: A
authors.lastname: Ierardi
authors.forename: F
authors.initials: F
authors.lastname: Nelli
authors.forename: F
authors.initials: F
authors.lastname: Del Corso
authors.forename: G
authors.initials: G
authors.lastname: Del Popolo
mesh_terms: D000328:Adult; D000368:Aged; D004599:Electric Stimulation Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012447:Sacrum / Q000294:innervation; D013118:Spinal Cord Diseases / Q000150:complications* / Q000175:diagnosis / Q000534:rehabilitation*; D016896:Treatment Outcome; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology / Q000534:rehabilitation; D001743:Urinary Bladder / Q000294:innervation; D001750:Urinary Bladder, Neurogenic / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*; D016055:Urinary Retention / Q000175:diagnosis / Q000209:etiology* / Q000534:rehabilitation*