Document Detail


Limited value of bladder sensation as a trigger for conditional neurostimulation in spinal cord injury patients.
MedLine Citation:
PMID:  19618446     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: Conditional stimulation of dorsal genital nerves suppresses undesired detrusor contractions (UDC) and consequently increases bladder capacity and prevents incontinence. No clinically applicable sensor exists for reliable bladder activity monitoring as a trigger for conditional stimulation. Primary objective of this study was to determine whether bladder sensation concomitant with UDC may be used for spinal cord injury (SCI) patients to trigger neurostimulation in daily life. METHODS: Nineteen male and 7 female SCI patients suspected of detrusor overactivity (DO) underwent conventional and 6-hr ambulatory urodynamics. Patients were instructed to do normal daily activities and to activate event buttons of the ambulatory recorder to mark events: physical activity, bladder sensation, micturition or intermittent catheterization, and urinary incontinence. Detection rate was defined as the number of recorded bladder sensation divided by the total number of recorded UDC during ambulatory urodynamics. RESULTS: Bladder sensation was reported by 73% of patients in daily life. Only 41% of patients had analyzable bladder sensation concomitant with UDC during ambulatory urodynamics. For ambulatory and conventional urodynamics, mean detection rates were 23% and 72%, respectively, with mean recording delays of 57 and 16 sec after UDC onset, respectively. CONCLUSIONS: Bladder sensation only occurs in a small group of SCI patients combined with a rather low detection rate and long reaction time. Therefore, bladder sensation as a trigger for conditional stimulation does not seem to be suitable for SCI patients with DO. Reliable techniques for chronic bladder activity monitoring are a prerequisite for successful clinical application of conditional stimulation.
Authors:
F M J Martens; H J M van Kuppevelt; J A C Beekman; N J M Rijkhoff; J P F A Heesakkers
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Neurourology and urodynamics     Volume:  29     ISSN:  1520-6777     ISO Abbreviation:  Neurourol. Urodyn.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-06-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8303326     Medline TA:  Neurourol Urodyn     Country:  United States    
Other Details:
Languages:  eng     Pagination:  395-400     Citation Subset:  IM    
Copyright Information:
(c) 2009 Wiley-Liss, Inc.
Affiliation:
Department of Urology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. f.martens@uro.umcn.nl
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Electric Stimulation
Female
Humans
Male
Middle Aged
Sensation*
Spinal Cord Injuries / physiopathology*
Urinary Bladder / physiopathology*
Urodynamics*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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