Article

The complications of neurogenic dysfunction of the urinary bladder
still constitute an important cause of death among spinal cord injury patients.
The aim of this study was to assess transcutaneous electrical
stimulation of the urinary bladder as a treatment for micturition disorders in
patients after spinal cord injury (SCI) over 2 years of follow-up.
METHODS: The study involved 28 patients (22 men and 6 women) with neurogenic
bladder dysfunction following a spinal cord injury. The patients were 16 to 68
years old and 2 to 26 months since their spinal cord injury.
The therapeutic
programme involved 30 sessions of electrical stimulation of the urinary bladder,
five sessions per week. The outcomes of electrical stimulation were assessed by
comparing the results of urodynamic examinations performed before treatment,
immediately on completion of the treatment and at 24 months post-treatment.
RESULTS: Transcutaneous electrical stimulation of the urinary bladder produced a
significant increase in bladder capacity (p = 0.001), which was higher by a mean
of 117.7 ml immediately on completion of the treatment and a mean of 101.6 ml (p
= 0.018) two years after the treatment. The amount of post-void residual urine in
the bladder decreased by a mean of 81.9 ml (p = 0.007) immediately after
completion of the treatment and a mean of 76.9 ml (p = 0.011) two years after the
treatment. Opening pressure was lower by a mean of 3.1 cm H(2)O (p > 0.05)
immediately on completion of the electrical stimulation treatment. Intravesical
pressure at maximum flow decreased in 19 patients (68%) by a mean of 11.6 cm
H(2)O (p > 0.05). At the late follow-up assessment, opening pressure was lower in
17 patients (68%) by a mean of 6.7 cm H(2)O. Two patients demonstrated the
micturition phase, which had been absent at baseline and immediately after
completion of the treatment. Opening pressure in the entire group was lower
compared to baseline by 2.9 cm H(2)O (p > 0.05). Also in the late follow-up
assessment, intravesical pressure at maximum flow was reduced in 21 patients
(79%) by a mean of 9.6 cm H(2)O (p > 0.05). The maximum voiding velocity
increased by a mean of 3.8 ml/s (p = 0.008) immediately after treatment
completion and by a mean of 3.6 ml/s (p < 0.001) at two years post-treatment.
CONCLUSIONS: Transcutaneous electrical stimulation of the neurogenic bladder in
patients following spinal cord injury improves lower urinary tract function.
Improved urinary tract function is seen two years following completion of the
electrical stimulation treatment.

Langue : ANGLAIS