Hansen J, Media S, Nøhr M, Biering-Sørensen F, Sinkjaer T, Rijkhoff N J M
Center for Sensory-Motor Interaction, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
J Urol. 2005 Jun;173(6):2035-9. doi: 10.1097/01.ju.0000158160.11083.1b.
The feasibility of automatic event driven electrical stimulation of the dorsal penile/clitoral nerve in the treatment of neurogenic detrusor overactivity (NDO) was evaluated in individuals with spinal cord injury.
The study included 2 women and 14 men older than 18 years with NDO, bladder capacity below 500 ml and complete or incomplete suprasacral spinal cord injury. Detrusor pressure (Pdet) was recorded during ordinary, natural bladder filling. In a similar subsequent recording Pdet was used to trigger electrical stimulation when pressure exceeded 10 cm H2O.
Of the 16 patients enrolled in this study 13 had increased bladder capacity together with a storage pressure decrease as a result of automatic, event driven electrical stimulation. In 2 patients stimulation could not inhibit the first undesired contraction, leakage occurred and finally 1 could not tolerate stimulation. During stimulated filling Pdet never exceeded 55 cm H2O. Thus, storage pressure was sufficiently low to prevent kidney damage. An average bladder capacity increase of 53% was achieved.
This study demonstrates the feasibility of automatic, event driven electrical stimulation in the treatment of NDO. Although the setup in this experiment is not suitable in a clinical setting, the treatment modality is promising and it warrants further investigation.
评估脊髓损伤患者中，阴茎背神经/阴蒂背神经自动事件驱动电刺激治疗神经源性逼尿肌过度活动（NDO）的可行性。
该研究纳入了16名年龄大于18岁的NDO患者，其中包括2名女性和14名男性，膀胱容量低于500ml，伴有完全或不完全骶上脊髓损伤。在正常自然膀胱充盈过程中记录逼尿肌压力（Pdet）。在随后的类似记录中，当压力超过10cm H2O时，使用Pdet触发电刺激。
在本研究纳入的16例患者中，13例因自动事件驱动电刺激导致膀胱容量增加，储尿压力降低。2例患者的刺激未能抑制首次不自主收缩，发生了漏尿，最后1例无法耐受刺激。在刺激充盈期间，Pdet从未超过55cm H2O。因此，储尿压力足够低，可防止肾损伤。膀胱容量平均增加了53%。
本研究证明了自动事件驱动电刺激治疗NDO的可行性。尽管本实验中的设置不适用于临床，但这种治疗方式很有前景，值得进一步研究。
