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KMID : 0361420110350050605
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Journal of Korean Academy of Rehabilitation Medicine
2011 Volume.35 No. 5 p.605 ~ p.612
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Semiconditional Electrical Stimulation of Pudendal Nerve Afferents Stimulation to Manage Neurogenic Detrusor Overactivity in Patients with Spinal Cord Injury
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Lee Young-Hee
Kim Jung-Moon
Im Hyung-Tae
Lee Kye-Wook
Kim Sung-Hoon
Hur Dong-Min
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Abstract
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Objective: To evaluate the eff ect of semiconditional electrical stimulation of the pudendal nerve aff erents for the neurogenic detrusor overactivity in patients with spinal cord injury. Forty patients (36 males, 4 males) with spinal cord injury who had urinary incontinence and frequency, as well as felt bladder contraction with bladder fi lling sense or autonomic dysrefl exic symptom participated in this study.
Method: Patients with neurogenic detrusor overactivity were subdivided into complete injury and incomplete injury groups by ASIA classifi cation and subdivided into tetraplegia and paraplegia groups by neurologic level of injury. Bladder function, such as bladder volumes infused to the bladder until the fi rst occurrence of neurogenic detrusor overactivity (Vini) and the last contraction suppressed by electrical stimulation (Vmax) was measured by water cystometry (CMG) and compared with the results of each subgroup.
Results: Among the 40 subjects, 35 patients showed neurogenic detrusor overactivity in the CMG study. Among these 35 patients, detrusor overactivity was suppressed eff ectively by pudendal nerve aff erent electrical stimulation in 32 patients. Th e infusion volume until the occurrence of the fi rst refl ex contraction (Vini) was 99.4±80.3 ml. Th e volume of saline infused to the bladder until the last contraction suppressed by semiconditional pudendal nerve stimulation (Vmax) was 274.3±93.2 ml, which was significantly greater than Vini. In patients with good response to the pudendal nerve aff erent stimulation, the bladder volume signifi cantly increased by stimulation in all the patients.
Conclusion: In this study, semiconditional electrical stimulation on the dorsal penile afferent nerve could effectively inhibit neurogenic detrusor overactivity and increase bladder volume in patients with spinal cord injury.
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KEYWORD
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Spinal cord injuries, Detrusor overactivity, Pudendal nerve, Electrical stimulation
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