THE USE OF ELECTRICAL DEVICES FOR THE TREATMENT OF BLADDER DYSFUNCTION: A REVIEW OF METHODS
- 1 September 2004
- journal article
- review article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 172 (3), 846-851
- https://doi.org/10.1097/01.ju.0000134418.21959.98
Abstract
We reviewed the literature on the application of various devices and techniques for the electrical stimulation treatment of lower urinary tract dysfunction with respect to mechanism of action and clinical outcome. A systematic review was done in PubMed of publications on intravesical stimulation, direct bladder stimulation, stimulation of the pelvic and pudendal nerves, transcutaneous-electrical nerve stimulation, stimulation of the sacral spine and roots, and lower limb stimulation. It is difficult truly to compare different treatment modalities because there are hardly any randomized placebo controlled studies. Also, there is considerable variety in treatment parameters and schedules reported as well as in criteria for success. Nevertheless, it can be said that electrical neurostimulation and neuromodulation result in a 30% to 50% clinical success on an intent to treat basis. Influencing lower urinary tract innervation at the level of sacral roots seems successful in neurological and nonneurological cases. It has the advantage of pretesting possibilities to improve patient selection and treatment outcome with the obvious drawback of invasiveness. Noninvasive techniques lack screening tests, making patient selection a matter of trial and error, and when there is success patients almost always need maintenance therapy. Randomized clinical trials to compare different techniques and evaluate placebo effects are urgently needed, as are further studies to elucidate modes of action to improve stimulation application and therapy results. The introduction of new stimulation methods may provide treatment alternatives as well as help answer more basic questions on electrical neurostimulation and neuromodulation.Keywords
This publication has 60 references indexed in Scilit:
- PERCUTANEOUS AFFERENT NEUROMODULATION FOR THE REFRACTORY OVERACTIVE BLADDER: RESULTS OF A MULTICENTER STUDYJournal of Urology, 2001
- Transcutaneous electrical stimulation of thigh muscles in the treatment of detrusor overactivityBJU International, 1998
- Concepts of neuromodulationNeurourology and Urodynamics, 1993
- Applications of neurostimulation in urologyNeurourology and Urodynamics, 1988
- Neural control of the urinary bladder: Possible relationship between peptidergic inhibitory mechanisms and detrusor instabilityNeurourology and Urodynamics, 1985
- Suppression of Bladder Instability by Penile SqueezeBritish Journal of Urology, 1982
- Spinal cord stimulation and bladder function in normal and paraplegic animalsJournal of Neurosurgery, 1972
- GUARD FOR INTRA-ANAL-PLUG ELECTRODEThe Lancet, 1969
- Treatment of stress incontinence by maximum perineal electrical stimulation.BMJ, 1967
- Use of a Radio Transmitter Receiver Unit for the Treatment of Neurogenic BladderJournal of Neurosurgery, 1962