Modulation of third sacral nerve (S3) activity is an effective treatment for irritative voiding dysfunction. Present techniques are invasive, requiring neurosdmulator implantation. We studied the effect of noninvasive transcutaneous S3 neurostimulation on bladder activity during filling. 30 patients (20 female, 10 male; mean age 47y) with irritative voiding dysfunction underwent standard filling cystometry at 50ml/minute. In the study group (n=15; 11 sensory urgency, 4 detrusor instability), the electrode pads of a BioTens transcutaneous neurostimulator were then affixed bilaterally to the S3 dermatomes. Current was applied at 10Hz frequency, 200ms pulse width in continuous mode at the maximum tolerable level. Neurostimulation continued throughout a second filling cystometry. The control group (n=15; 11 sensory urgency, 4 detrusor instability) underwent second fill cystometry without neurostimulation. For second fill cystometry, mean ± standard error of bladder volumes (ml) and detrusor pressures (cm Hjp) values were measured. Statistical analysis was performed by Mann-Whitney U non-parametric testing: CYSTOMETRY CONTROL NEUROSTIMULATION p value FDV 132±2.7 177.9±2.3 0.03 PDet at FDV 11.4±0.5 4.9±0.3 0.03 CMax 311.5±6.1 470.6±6.1 0.005 PDet at CMax 39.9±2.1 24.4±0.7 0.004 FDV = first desire to void; PDet = detrusor pressure; CMax = maximum cystometric bladder capacity. Transcutaneous stimulation of the third sacral nerve produces significant improvements in urodynamic bladder volumes and pressures in patients with irritative voiding dysfunction. This noninvasive, ambulatory technique may be an effective treatment option for such patients.
|Number of pages||1|
|Journal||British journal of urology|
|Issue number||SUPPL. 2|
|Publication status||Published - 01 Dec 1997|
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