Patient controlled versus automatic stimulation of pudendal nerve afferents to treat neurogenic detrusor overactivity

The Journal of Urology
E OpissoN J M Rijkhoff

Abstract

We investigated whether patients with neurogenic detrusor overactivity can sense the onset of bladder contraction and in turn suppress the contraction by electrical stimulation of the dorsal penile-clitoral nerve. A total of 67 patients with different neurological disorders were recruited to undergo 3 filling cystometries. The first cystometry was done without stimulation. The second cystometry was performed with automatic controlled stimulation based on detrusor pressure. The third cystometry was done with patient controlled stimulation using a push button. Four females and 13 males underwent all 3 fillings. Compared to cystometry 1 average bladder capacity for cystometries 2 and 3 was 60% higher. Compared to peak pressure for cystometry 1 average peak pressure during suppressed contractions for cystometries 2 and 3 was 49% and 26% lower, respectively. The average delay of the onset of stimulation during cystometry 3 with respect to cystometry 2 was 5.7 seconds. The study shows that patient controlled genital nerve stimulation is as effective as automatic controlled stimulation to treat neurogenic detrusor overactivity. Thus, patient controlled stimulation is feasible in select patients, although patients must be trained in th...Continue Reading

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Citations

Aug 7, 2012·Current Urology Reports·Fawzy F FaragJohn P F A Heesakkers
Aug 22, 2014·Current Opinion in Urology·Niels V JohnsenRoger R Dmochowski
Feb 24, 2016·Frontiers in Neuroscience·Hendrikje M K van BredaNico J M Rijkhoff
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Jan 16, 2018·The Journal of Spinal Cord Medicine·Dennis J BourbeauSteven W Brose
Jul 26, 2019·Evidence-based Complementary and Alternative Medicine : ECAM·Shauh-Der YehChih-Wei Peng
Feb 12, 2017·The Journal of Spinal Cord Medicine·Steven W BroseKenneth J Gustafson
Apr 24, 2018·World Journal of Urology·Jean-Jacques WyndaeleNoritoshi Sekido

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