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Abstract
In patients suffering from neurogenic detrusor overactivity, continence can be regained by conditional stimulation of the dorsal genital nerve (DGN); that is applying electrical stimulation to the DGN at the onset of an involuntary contraction. For this scheme to work, a sensor capable of reliably detecting the onset of bladder contractions is needed. This article reviews the methods proposed for or associated with detection of bladder contractions, and their applicability to onset detection is assessed. Fourteen methods are described in this review; bladder pressure, urethral sphincter EMG and anal sphincter EMG are the most promising options for onset detection. For all three modalities, however, further research is needed before clinical application becomes viable.
Highlights
The central nervous system plays a vital role in the storage and periodical release of urine
Most patients with lesions to the central nervous system, e.g. disorders such as spinal cord injury, multiple sclerosis, Parkinson’s disease and similar, develop neurogenic detrusor overactivity (NDO) [2]. Many of these patients develop detrusor-sphincter-dyssynergia (DSD), which is the concurrent contraction of the detrusor and the urethral sphincters [3]. Patients with both NDO and DSD may suffer from incontinence episodes
This review aims to give an overview of methods proposed in the literature
Summary
The central nervous system plays a vital role in the storage and periodical release of urine. Most patients with lesions to the central nervous system, e.g. disorders such as spinal cord injury, multiple sclerosis, Parkinson’s disease and similar, develop neurogenic detrusor overactivity (NDO) [2]. Many of these patients develop detrusor-sphincter-dyssynergia (DSD), which is the concurrent contraction of the detrusor and the urethral sphincters [3]. Despite this antagonistic action, patients with both NDO and DSD may suffer from incontinence episodes.
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