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Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury.

Publication ,  Journal Article
Horvath, EE; Yoo, PB; Amundsen, CL; Webster, GD; Grill, WM
Published in: Neurourol Urodyn
March 2010

AIMS: Individuals with spinal cord injury (SCI) exhibit neurogenic detrusor overactivity (NDO) causing high intravesicle pressures and incontinence. The first aim was to measure changes in maximum cystometric capacity (MCC) evoked by electrical stimulation of the dorsal genital nerve (DGN) delivered either continuously or conditionally (only during bladder contractions) in persons with SCI. The second aim was to use the external anal sphincter electromyogram (EMG(EAS)) for real-time control of conditional stimulation. METHODS: Serial filling cystometries were performed in nine volunteers with complete or incomplete supra-sacral SCI. Conditional stimulation was delivered automatically when detrusor pressure increased to 8-12 cmH(2)O above baseline. MCCs were measured for each treatment (continuous, conditional, and no stimulation) and compared using post-ANOVA Tukey HSD paired comparisons. Additional treatments in two subjects used the EMG(EAS) for automatic control of conditional stimulation. RESULTS: Continuous and conditional stimulation increased MCC by 63 +/- 73 ml (36 +/- 24%) and 74 +/- 71 ml (51 +/- 37%), respectively (P < 0.05), compared to no stimulation. There was no significant difference between MCCs for conditional and continuous stimulation, but conditional stimulation significantly reduced stimulation time (174 +/- 154 sec, or 27 +/- 17% of total time) as compared to continuous stimulation (469 +/- 269 sec, 100% of total time, P < 0.001). The EMG(EAS) algorithm provided reliable detection of bladder contractions (six of six contractions over four trials) and reduced stimulation time (21 +/- 8% of total time). CONCLUSIONS: Conditional stimulation generates increases in bladder capacity while substantially reducing stimulation time. Furthermore, EMG(EAS) was successfully used as a real-time feedback signal to control conditional electrical stimulation in a laboratory setting.

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Published In

Neurourol Urodyn

DOI

EISSN

1520-6777

Publication Date

March 2010

Volume

29

Issue

3

Start / End Page

401 / 407

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urodynamics
  • Urinary Bladder, Overactive
  • Urinary Bladder, Neurogenic
  • Urinary Bladder
  • Spinal Cord Injuries
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

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Horvath, E. E., Yoo, P. B., Amundsen, C. L., Webster, G. D., & Grill, W. M. (2010). Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury. Neurourol Urodyn, 29(3), 401–407. https://doi.org/10.1002/nau.20766
Horvath, Eric E., Paul B. Yoo, Cindy L. Amundsen, George D. Webster, and Warren M. Grill. “Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury.Neurourol Urodyn 29, no. 3 (March 2010): 401–7. https://doi.org/10.1002/nau.20766.
Horvath EE, Yoo PB, Amundsen CL, Webster GD, Grill WM. Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury. Neurourol Urodyn. 2010 Mar;29(3):401–7.
Horvath, Eric E., et al. “Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury.Neurourol Urodyn, vol. 29, no. 3, Mar. 2010, pp. 401–07. Pubmed, doi:10.1002/nau.20766.
Horvath EE, Yoo PB, Amundsen CL, Webster GD, Grill WM. Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury. Neurourol Urodyn. 2010 Mar;29(3):401–407.
Journal cover image

Published In

Neurourol Urodyn

DOI

EISSN

1520-6777

Publication Date

March 2010

Volume

29

Issue

3

Start / End Page

401 / 407

Location

United States

Related Subject Headings

  • Urology & Nephrology
  • Urodynamics
  • Urinary Bladder, Overactive
  • Urinary Bladder, Neurogenic
  • Urinary Bladder
  • Spinal Cord Injuries
  • Middle Aged
  • Male
  • Humans
  • Female