MP52-10 CHRONIC, NON-INVASIVE NERVE STIMULATION THERAPY TO TREAT INCONTINENCE IN PEOPLE WITH NEUROGENIC BLADDER

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP52-10 CHRONIC, NON-INVASIVE NERVE STIMULATION THERAPY TO TREAT INCONTINENCE IN PEOPLE WITH NEUROGENIC BLADDER Seth Meade, Dennis Bourbeau, Steven Brose, Kenneth Gustafson, Cesar Colasante, and Kevin Suarez Seth MeadeSeth Meade More articles by this author , Dennis BourbeauDennis Bourbeau More articles by this author , Steven BroseSteven Brose More articles by this author , Kenneth GustafsonKenneth Gustafson More articles by this author , Cesar ColasanteCesar Colasante More articles by this author , and Kevin SuarezKevin Suarez More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003300.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Reduction of urinary urgency and incontinence is a top priority for individuals with neurogenic bladder (NB). Multiple clinical studies show non-invasive genital nerve stimulation (GNS) can modulate sympathetic reflexes to inhibit bladder contractions acutely and is well-tolerated. To translate GNS as an effective adjunct therapy for managing neurogenic bladder, further evidence of chronic efficacy and feasibility is needed. METHODS: In this “before-and-after” prospective cohort study, participants acted as their own controls. 9 individuals with NB were enrolled (8/9 (88.9%) male) and confirmed to: 1) have NB by urodynamics examination and 2) have bladder contractions inhibited by GNS. 5 participants (100% male) who tolerated GNS without additional medications and were adherent to voiding diaries tested the efficacy of at-home, self-administered GNS using a commercial TENS unit. Participants completed voiding diaries, each detailing at least 1 continuous week of tracked voiding, leak, and urgency events. Diaries were completed once at study initiation during a control period without GNS or medications, and then for 3 separate periods during prolonged use of GNS to manage incontinence (baseline, 6 months, 1 year). Participants also completed a bladder-related quality of life questionnaire (Qualiveen) at their initial evaluation, as well as 6 and 12 months later. RESULTS: Preliminary findings show that GNS increased bladder capacity for all 9 individuals tested by an average of 58%, and 3/5 individuals tested chronically maintained an increased bladder capacity after 6 months of GNS. 4/5 individuals reported increased bladder-related QOL by total Qualiveen after 6 months of at-home GNS. Of 2 individuals who experienced leakage with chronic voiding data one reduced their leaks/day by 90% at 6 months of use and the other by 30% at 1 year of GNS. Of 2 individuals with the primary goal of reducing bladder urgency, neither was able to reduce their urgency events/day but were able to reduce their voiding frequency by 65% and 15% after more than 1 month of use. The primary reason individuals reported for dropping from the study was difficulty placing the electrodes and keeping them in place. CONCLUSIONS: GNS can provide a durable reduction in leakage events for individuals with incontinence due to neurogenic bladder up to 6 months. Multiple subjects reported issues with electrode placement and adhesion as well as associated wires from the TENS unit leading to less-than-ideal GNS for some. Source of Funding: -RX002512 Department of Veterans Affairs -642810 Craig H. Neilsen Foundation (CHNF) © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e706 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Seth Meade More articles by this author Dennis Bourbeau More articles by this author Steven Brose More articles by this author Kenneth Gustafson More articles by this author Cesar Colasante More articles by this author Kevin Suarez More articles by this author Expand All Advertisement PDF downloadLoading ...