Article

OBJECTIVES: To compare the efficacy of intravesical electrostimulation (IVES)
versus sacral neuromodulation (SNM) in patients with incomplete spinal cord
lesions (SCL) and neurogenic non-obstructive urinary retention (N-NOR). METHODS:
In this retrospective study, 77 N-NOR patients underwent IVES (minimum 28
sessions), then after returning to voiding baseline symptoms, percutaneous first
stage of SNM (lasting for minimum 4 weeks). After the two neuromodulation
treatments, responders were categorized as patients experiencing both a 50%
reduction of volume per catheterization per ml and a 50% reduction in number of
catheterizations per day when comparing the 7-day voiding diaries at the end of
both procedures to baselines. New urodynamics were performed subsequently.
Responders to first stage of SNM underwent permanent SNM. RESULTS: Forty-eight
patients responded to neither of the treatments, whereas 29 responded to both
IVES and first-stage SNM. No significant statistical differences (P>0.05) were
detected in the voiding diaries. Following the two procedures, the first
sensation of bladder filling was either maintained or recovered by all
responders, whereas the same 11 patients reached a bladder contractility index of
>100. The 29 IVES responders lost their clinical benefits in a mean follow-up of
9.6 months. Only 10 out of the 29 patients became nonresponsive to permanent SNM,
in a mean follow-up of 54 months. CONCLUSION: A strict correlation in terms of
clinical and urodynamic patterns was demonstrated in patients with incomplete SCL
and N-NOR, following IVES and first stage of SNM. However, voiding improvement
through IVES was short-term when compared with the effects of permanent SNM.

Langue : ANGLAIS