Article

OBJECTIVE: To evaluate the clinical and urodynamic impact of intravesical
electrostimulation (IVES) on incomplete spinal cord injury (SCI) patients
suffering from chronic neurogenic non-obstructive urinary retention (N-NOR).
METHODS: One-hundred and two patients underwent at least 28 consecutive daily
IVES sessions because objective evidence of detrusor acontractility instead of
hypocontractility was detected. Diary entries written at various stages by each
patient were compared (7 days before the IVES cycle, 15-21 days into the cycle
and 7 days before its end). Responders were patients with a mean 50% reduction in
both the number of daily catheterizations and post-void residual urine.
Responders underwent further urodynamics at the end of the IVES cycle; patients
experiencing first sensation of bladder filling, and the mean volume of first
sensation of bladder filling per ml, Qmax ml s(-1), among others, were evaluated.
Nineteen individuals who repeated another IVES round were included in this study.
RESULTS: Thirty-eight subjects (37.2%) responded to IVES and of those, 83.3%
recovered the first sensation of bladder filling after the IVES round. Nineteen
responders repeated IVES within 1 year, owing to loss of efficacy. They obtained
similar voiding symptoms improvement and urodynamic results as after the first
IVES cycle. A timespan of <2 years from SCI to IVES, and the presence of first
sensation of bladder filling at baseline represented significant predictive
parameters for IVES success (P<0.05) using chi(2)-test. CONCLUSIONS: IVES
represents a possible therapeutic option for incomplete SCI patients with N-NOR.

Langue : ANGLAIS