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  4. Electrical stimulation for the treatment of lower urinary tract dysfunction after spinal cord injury

Electrical stimulation for the treatment of lower urinary tract dysfunction after spinal cord injury

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000299 · Published: April 1, 2015

Spinal Cord InjuryUrologyNeurology

Simple Explanation

Electrical stimulation offers an alternative approach to managing bladder control issues resulting from spinal cord injuries, contrasting with traditional methods for neurogenic lower urinary tract dysfunction (NLUTD). This review explores the use of electrical stimulation for bladder control after spinal cord injury, covering clinical applications and recent pre-clinical studies that suggest new strategies. The review suggests that combining targeted electrical stimulation with medication might be the best way to regain bladder control after a spinal cord injury.

Study Duration
Not specified
Participants
Not specified
Evidence Level
Review

Key Findings

  • 1
    Electrical stimulation techniques, including pudendal nerve stimulation and high-frequency nerve block, show promise in controlling bladder function.
  • 2
    Sacral anterior root stimulation (SARS) has been a successful electrical stimulation method for bladder control in SCI patients, but its use is limited due to the requirement for posterior rhizotomy and the complexity of the surgery.
  • 3
    Pudendal nerve stimulation (PNS) can produce bladder inhibition or activation, and may be a useful alternative to sacral nerve stimulation (SNS) for treating NLUTD following SCI.

Research Summary

This review discusses neurogenic lower urinary tract dysfunction (NLUTD) following spinal cord injury and the development of electrical stimulation as an approach to restore bladder function, including both continence and micturition. Different locations have been investigated for application of electrical stimulation to restore functional bladder control, each with varying degrees of success. The optimal solution for restoration of bladder control after SCI may encompass a combination of efficient, targeted electrical stimulation, possibly at multiple locations, and pharmacological treatment to enhance symptom control.

Practical Implications

Improved Bladder Control

Electrical stimulation techniques, particularly PNS, offer a potential pathway to improve both continence and micturition in individuals with SCI.

Reduced Reliance on Medications

Targeted electrical stimulation, possibly combined with pharmacological treatment, could decrease the need for high doses of anticholinergic drugs and their associated side effects.

Development of Personalized Therapies

Further understanding of the mechanisms of action of electrical stimulation will allow for the development of more efficient and targeted therapies, tailored to individual patient needs.

Study Limitations

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