[Results of the treatment of children with neurogenic bladder by transurethral intravesical electric stimulation].

Abstract

The intravesical transurethal electrostimulation was introduced by F. Katona in order to create consciously controlled micturition in patients with neurogenic bladder lesions. The principle of therapy is based on the activation of the intramural receptors and vegetative pathways from the bladder with special exponential electric impulses. The electric stimulation should evoke the bladder sensation and finally the conscious urge to void might develop. Simultaneously the detrusor tonus should be normalised and evoked contractions become stronger and organised, to be able to empty bladder in stream. During the period from May 1977 to October 1980, 24 children with neurogenic urinary incontinence (aged 2-18 years), were treated in the Surgical Department of the Institute of Mother and Child. Most of them have been operated on for meningomyelocoele , 1--for spinal ependymoma, 1--suffered from extensive haemangioma of pelvic brim and spine, 1 child had no obvious signs of dysraphism. The therapeutic programme consisted of 2 series of 40 stimulations in each serie , applied every day. Each session lasted 90 minutes. The current parameters were: intensity of exponential waves, steadily increasing from 0,4 to 6 m A, frequency 70 Hz, impulse duration 5 msek . Before treatment the clinical, neurological and radiological evaluation were done. The extension of neurologic deficite and state of urinary tract were assessed. Every child had IVP and micturition cystourethrography. Since 1978 the urodynamic investigations were introduced. Cystometry was performed before and after each serie of stimulation. Since 1979 the measuring of urethral pressure profile was included, for more exact evaluation of the type of bladder lesion.(ABSTRACT TRUNCATED AT 250 WORDS)