Sacral neuromodulation in treatment of neuromuscular dysfunction of the bladder in patients with spinal cord injury: test phase

Abstract

Objective. То study the effectiveness criteria and the need to convert patients from the test stage of sacral neuromodulation (SNM) to permanent sacral neuromodulation.

Materials and methods. 60 patients with spinal cord injury and the presence of neuromuscular bladder dysfunction were studied. Of these patients, after a joint consultation of a neurologist, urologist and neurosurgeon, 30 patients were selected to perform test sacral neuromodulation: 15 women and 15 men, the average age of the patients was 42,2±13,2 years. Patients in the acute period after injury were excluded from the study. The average time since injury was 11,0±9,6 years.

Results. Patients in group A with a hyperreflexive bladder showed more pronounced positive changes in the main indicators taken as criteria for the effectiveness of the test phase of SNM. One patient from group В did not improve in any of the parameters; therefore, the installed electrode was removed from him and he was excluded from the study. Thus, 29 out of 30 patients (96,6 %) received a permanent sacral neuromodulator after evaluation of the test phase.

Conclusion. A decrease in the number of daily micturitions and self-catheterizations, a decrease in the volume of residual urine and an improvement in the quality of life by 50 % or more from the initial data are not only positive effects of the test phase of sacral neuromodulation, but also predictors of the success of permanent sacral neuromodulation.