Dorsal Genital Nerve Stimulation as an Adjunctive Therapy to Control Neurogenic Detrusor Overactivity After Spinal Cord Injury.

Abstract

Background: Spinal cord injury (SCI) causes impairment to bladder function. As current management strategies are not fully effective, there remains a need for alternative or adjunctive management options. Dorsal genital nerve stimulation (DGNS) has been shown to effectively inhibit unwanted bladder contractions in people with SCI. However, the acceptance and beneficial effects of home-based DGNS have not yet been proven.

Methods: This pilot trial investigated the feasibility and user acceptance of a novel DGNS device, UCon (InnoCon Medical, Denmark) when used at home by people with SCI for 8 weeks. Cystometry with and without DGNS was performed before and after the intervention. Outcome measures included 3-day bladder diaries (3DBD), quality of life, and user acceptance questionnaires, and a semi-structured interview.

Results: Ten people with chronic SCI and neurogenic detrusor overactivity participated in the trial and used the device at home for 8 weeks. When tested at baseline, DGNS significantly increased maximum cystometric capacity (MCC) from 276 (125) to 394 (147) ml with DGNS applied (p < 0.001). After the 8-week intervention, no change in MCC without stimulation was noted. No change in bladder capacity or incontinence episodes was found from 3DBDs and quality of life was not significantly changed. User acceptance of the device was high, with some issues noted, particularly around device disconnection.

Conclusions: Our results support the application of DGNS to increase bladder capacity after SCI, and user acceptance of home-based DGNS was high. This therapy should be studied in a larger subject group to prove the effectiveness of home-based DGNS.