[Stimulation or blocking of the periurethral region--an expansion of conservative therapeutic measures in irritable bladder and urge incontinence].

In an open study we report about the therapeutic influence of neural therapy in the periurethral region in patients with urgency. We treated 50 patients with neurohormonal urgency three times in 2-weeks interval by periurethral injections of 10 ml 0.25% Bupivacaine. Success was controlled in 46 patients with clinical and urodynamical methods. 10% of the least one time treated patients had the same complaints after therapy, 60% were improved by therapy and 30% were free of symptoms. We registered with urodynamic measurements a significant increase of the bladder volume up to the first sensation to void and a significant reduction of the bladder compliance. In a second randomized study the influence of a single acute maximum functional electrostimulation (AMFES) by vaginal electrode was tested. 10 patients with anamnestic urge incontinence in each case with uninhibited detrusor contractions and 10 patients without detrusor contractions was treated. The subjective statements yielded in urge incontinence without detrusor contractions a higher percentage of improvement than in motoric urge incontinence. The urodynamic diagnostic evaluation showed a relation between the unchanged objective conditions and the symptoms of complaint four weeks after treatment in patients with motoric urge incontinence. We recommend the use both of the neural therapy and functional electrostimulation as additional methods besides the dominant medicamentous treatment of the urgency and the urge incontinence.