The role of electrostimulation in the treatment of neurogenic bladder resulting from spinal cord injury

H. Zieliński, Cz. Pawlak, R. Święcicki, S. Sosnowski, T. Ząbkowski

H. Zieliński, Cz. Pawlak, R. Święcicki, S. Sosnowski, T. Ząbkowski – The role of electrostimulation in the treatment of neurogenic bladder resulting from spinal cord injury. Fizjoterapia Polska 2004; 4(1); 25-30

Abstract

Background. The task of conservative treatment in neurogenic urinary disorders is to prevent damage to the upper urinary tract by lowering intra-bladder pressure and increasing bladder capacity during urine collection, and to facilitate voiding. The purpose of the present study is to evaluate neurostimulation of the bladder as a method to improve functioning in the lower urinary tract in respect to intra-bladder pressure, bladder capacity, and voiding.Material and method. We studied 11 patients (2 women and 9 men, including 3 with cervical SCIs and 6 with lumbo-sacral injuries) hospitalized in the Post-Traumatic Paraplegia Clinic at the 10th Military Hospital in Bydgoszcz, Poland. All these patients were subjected to urodynamic testing before and after electrostimulation of the bladder. Transcutaneous electrodes were applied, placed above the pubic symphysis and in the sacral region, with impulse current, single- or double-phase, triangle or square shape, lasting 1-10 milliseconds, at a frequency of 20-100 Hz. Each patient received an average of 27 electrostimulation procedures. Results. A majority of the patients achieved increased bladder capacity, reduced retention, and reduced intra-bladder tension. In three cases, urination that was completely absent at baseline was present in follow-up urodynamic testing after the application of electrostimulation. Conclusions. Electrostimulation of the neurogenic bladder in SCI patients is in most cases a treatment method significantly reducing the risk factors for damage to the upper urinary tract. Electrostimulation must be accompanied by urodynamic testing to objectivize outcome measurements and evaluate the danger to the upper urinary tract.

Key words:
neurogenic bladder dysfunction, urodynamic test, ingurinary complications of SCI
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