Electrical stimulation in the treatment of neurogenic bladder dysfunction

Abstract

Voiding and storage of urine are performed by the urinary bladder and the urethra, which are neurally controlled by the sacral nerves. Neurologic disturbances can infl uence switching between storage and voiding that results in voiding dysfunction, leading to neurogenic bladder. Causes of neurogenic bladder dysfunction include spinal cord injury or trauma; central nervous system tumors; demyelinating disease involving the spinal cord; spinal cord ischemia; cerebral palsy; and myelomeningocele, which is the most common cause of neurogenic bladder dysfunction in children. This article provides information about neurogenic bladder dysfunction and the current treatment options using electrical neuromodulation, comparing the various available modalities.

Effects of Electroacupuncture on Bladder and Bowel Function in Patients with Transverse Myelitis: A Prospective Observational Study

“… 35 Nonetheless, these complicated surgical procedures and their related side effects, as well as the associated costs, may well be unacceptable to some patients. 36 …”

Effects of percutaneous posterior tibial nerve stimulation on voiding dysfunctions in cerebral palsy: A case report

“…He concluded that sensory and motor nerves of the anterior roots conduct impulses, while the posterior nerve roots responsible for vital functions [5].…”

“…In 1983, McGuire and colleagues first reported the posterior tibial nerve electrical stimulation [5]. Many other studies reported the use of PTNS in neurogenic and nonneurogenic patients with urgency, frequency, urge incontinence and voiding dysfunctions [9,11,12].…”

“…Sacral neuromodulation, requiring a permanent implanted stimulator, is less suitable for children because implant doesn't grow with the patient [5]. Physiotherapy treatments including pelvic floor muscle training [6], biofeedback [7], posterior tibial nerve stimulation, interferential, para sacral, suprapubic, anogenital and intra anal electrical stimulation [4].…”

“…Physiotherapy treatments including pelvic floor muscle training [6], biofeedback [7], posterior tibial nerve stimulation, interferential, para sacral, suprapubic, anogenital and intra anal electrical stimulation [4]. The posterior tibial nerve is a mixed nerve containing (L5-S3) fibers, originating from the same spinal segments as the parasympathetic innervations to the bladder [5]. The aim of this study was to investigate the efficacy of the noninvasive technique of transcutaneous posterior tibial nerve stimulation (TPTNS) in CP children with nonobstructive urinary retention.…”