Experiences and Critical Comments on the Temporary Intravesical Electrostimulation of the Neurogenic Bladder in Spina bifida Children

Abstract

This is a report of a special method of a temporary intravesical electrostimulation of the bladder for the treatment of the urinary incontinence of spina bifida children. The technique with presentation of apparatus and catheter is described in detail. The criterias for the selection of the patients are explained, the most important of which is the response of the detrusor muscle during the stimulation recorded by uromanometry. 26 spina bifida children were treated. There is at least a success in 50% of the patients, if the criteria are fulfilled.

Management of urinary incontinence in children with myelomeningocele

“…Stimulation parameters varied according to cystometric findings. In patients with detrusor contractions the impulse package parameters were: impulse duration 5 ms, frequency 100 Hz, duration of pulse train 7 s, and rise time (the time until the maximum selective current is achieved) 1 s. In the patients with detrusor areflexia the parameters were: impulse duration 5 ms, frequency 70 Hz, duration of pulse train 4 s and rise time 3 s. The slower stimulation in the case of patients with detrusor areflexia was chosen in an attempt to build up a bladder contraction but both types of stimulations have been shown to be optimal for evoking detrusor contractions (6). The intensity of the current varied between 6 and 12 mA depending on the tolerance of the patient.…”