Neuro-urology Department Florence, Spinal Unit, Spinal Unit Florence, Florence, Italy.
Spinal Cord. 2013 Mar;51(3):232-7. doi: 10.1038/sc.2012.120. Epub 2012 Oct 30.
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).
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.
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 χ(2)-test.
IVES represents a possible therapeutic option for incomplete SCI patients with N-NOR.
评估腔内电刺激（IVES）对患有慢性神经源性非梗阻性尿潴留（N-NOR）的不完全性脊髓损伤（SCI）患者的临床和尿动力学影响。
102 名患者接受了至少 28 次连续每日 IVES 治疗，因为检测到逼尿肌无收缩而不是收缩力降低的客观证据。比较每位患者在不同阶段的日记条目（在 IVES 周期前 7 天、周期中 15-21 天和周期结束前 7 天）。应答者是每日导尿次数减少 50%且残余尿量减少 50%的患者。在 IVES 周期结束时，应答者接受进一步的尿动力学检查；评估患者首次感觉膀胱充盈的情况以及首次感觉膀胱充盈的平均容量（ml/每毫升）、Qmax（ml/s）等。在本研究中，还包括了 19 名重复另一个 IVES 周期的个体。
38 名患者（37.2%）对 IVES 有反应，其中 83.3%在 IVES 周期后恢复了首次感觉膀胱充盈的能力。19 名应答者在 1 年内因疗效丧失而重复进行 IVES。他们获得了类似的排尿症状改善和尿动力学结果。使用 χ(2)-检验，SCI 后到 IVES 的时间间隔<2 年以及基线时存在首次感觉膀胱充盈是 IVES 成功的显著预测参数（P<0.05）。
IVES 是治疗 N-NOR 不完全性 SCI 患者的一种可行的治疗选择。
