Maximal electrical stimulation in neurogenic detrusor hyperactivity: experiences in multiple sclerosis.

OBJECTIVES

We report our experiences with maximal tolerable electrical stimulation in neurogenic bladder dysfunction due to multiple sclerosis.

METHODS

27 female patients were treated with an intravaginal electrode carrier and an external pulse generator. The devices were individually adjustable with respect to electrode positioning and stimulation parameters. The frequency was 20 Hz. The threshold for sensation of the electrical stimulus was determined by slowly increasing the current and care was taken to stimulate with maximal tolerable stimuli. Urodynamic evaluation was done before and after cessation of treatment.

RESULTS

During stimulation, 85% of the patients were free of symptoms. Three months after cessation of treatment only 18% remained free of symptoms, but the symptoms were not as pronounced as before treatment.

CONCLUSION

Electrical stimulation using intravaginal electrodes represents a practical technical choice to treat motor urge incontinence in multiple sclerosis patients, although chronic stimulation is needed to retain improvement.