The effect of transcutaneous neurostimulation on filling cystometry
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Introduction: Modulation of third sacral nerve (S3) activity is an effective treatment for irritative voiding dysfunction. Present techniques are invasive, requiring the implantation of a neurostimulator. We examined the effect of non-invasive transcutaneous S3 neurostimulation on bladder activity during filling. Patients and methods: Thirty-two patients (21 women and 11 men. mean age 48 years) with irritative voiding dysfunction (22 sensory urgency and 10 detrusor instability) underwent standard filling cystometry at 50 mL/min. In the 16 patients in the study group, the electrode pads of a BioTens transcutaneous neurostimulator were taped bilaterally to the S3 dermatomes. Current (10 mA) was applied at 10 Hz, and a 200 ins pulse-width in continuous mode at the maximum tolerable level. Neurostimulation was performed throughout a second filling cystometry. The control group of 16 patients underwent second-fill cystometry without neurostimulation. Results: Bladder volume and detrusor pressure values for second-fill cystometry for the two groups were as shown in the table. Mean (SEM) Neuro- P (Mann-Cystometry Control stimulation Whitney U) First desire to void (mL) 136 (2.9) 176.9(2.6) 0.05 Pressure at first desire 10.1 (0.4) 5.1(0.2) 0.04 to void (cmH 2O) Maximum capacity (mL) 307.5 (5.9) 461.6 (5.4) 0.03 End-fill pressure (cmH 2O) 40.1(2.0) 24.2(0.6) 0.03 Conclusion: Transcutaueous stimulation of the third sacral nerve produces significant improvements in urodynamic bladder volumes and pressures in patients with irritative voiding dysfunction. This non-invasive, ambulatory technique may be a useful treatment option for such patients.
|Number of pages||1|
|Journal||British journal of urology|
|Journal publication date||01 Dec 1997|
|Issue number||SUPPL. 4|
|State||Published - 01 Dec 1997|