Conditional neuromodulation of neurogenic detrusor overactivity using transrectal stimulation in patients with spinal cord injury: A proof of principle study

A proof of principle study of a novel wearable device to control neurogenic detrusor over-activity in eight male spinal cord injured subjects using conditional neuromodulation.

Transrectal stimulation was delivered through the device in response to simultaneously recorded external anal sphincter (EAS) contraction as a marker for neurogenic detrusor overactivity (NDO). The effect of conditional neuromodulation on bladder capacity and maximum detrusor pressure was investigated in addition to reliability of dyssynergic sphincter contraction as a marker for NDO.

Conditional neuromodulation through the novel device showed a statistically significant increase in bladder capacity and reduction in maximum detrusor pressure in six male subjects with spinal cord injury (SCI). EAS activity was a reliable surrogate for detection of NDO.

It has been shown for the first time that conditional neuromodulation can be delivered and triggered via a single biocompatible device placed in the anal canal. The pudendal nerves lying in Alcock's canal were stimulated through the wall of the anal canal, and the dyssynergic activity of the EAS was used to detect NDO and trigger neuromodulation giving significant increases in bladder capacity and reduction in detrusor pressure in six male subjects with SCI.

Neurourology and urodynamics. 2017 Jun 30 [Epub ahead of print]

Sarah Louise Knight, Nuwani Edirisinghe, Brian Leaker, Judith Susser, Michael Duncan Craggs

London Spinal Cord Injury Centre, Royal National Orthopaedic Hospital, Stanmore, UK., Department of Medical Physics Bioengineering, University College London, London, UK., Nephro-Urology Clinical Trials Ltd., Queen Anne Street Medical Centre, London, UK.

Pelvic Health Weekly Newsletter