Conditional stimulatzion of the dorsal penile/clitoral nerve may increase cystometric capacity in patients with spinal cord injury

Aims To investigate the feasibility of conditional short duration electrical stimulation of the penile/clitoral nerve as treatment for detrusor hyperreflexia, the present study was initiated. Methods Ten patients with spinal cord injury, 4 women and 6 men, with lesions at different levels above the sacral micturition center had a standard cystometry performed. During a subsequent cystometry, conditional short duration electrical stimulation of the penile/clitoral nerve was performed as treatment for one or more detrusor hyperreflexic contractions. Resuts In all patients, at least one contraction (mean, 7.8; range, 1–16 contractions) was inhibited by the stimulations. The mean cystometric capacity was increased significantly by conditional electrical stimulation, from 210 mL in the control cystometries to 349 mL in the stimulation cystometries (P=0.016). The maximal detrusor pressure during the first contraction in the control cystometries was mean 51 cm H2O, whereas the maximal pressure of the first contraction in the stimulation cystometries was reduced to mean 33 cm H2O (P=0.045). Conclusions The authors conclude that repeated conditional short duration electrical stimulation significantly increased cystometric capacity in patients with spinal cord injury. The increase was caused mainly by an inhibition of detrusor contractions. The need for a reliable technique for chronic bladder activity monitoring is emphasized, as it is a prerequisite for clinical application of this treatment modality. Neurourol. Urodynam. 22:130–137, 2003. © 2003 Wiley-Liss, Inc.