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Journal of the Korean Academy of Rehabilitation Medicine 2001;25(6):956-964.
Inhibition of Hyper-reflexic Detrusor Contraction by Sacral Afferent Nerve Stimulation in Spinal Cord Injury.
Lee, Jong Min , Lee, Young Hee , Lee, Sang Shin , Jang, Sang Min , Song, Jae Man , Song, Ki Hak
1Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Korea.
2Department of Urology, Yonsei University Wonju College of Medicine, Korea
척수손상인에서 구심성 천수신경 자극을 이용한 방광 과반사 억제
이종민, 이영희, 이상신, 장상민, 송재만1, 송기학1
연세대학교 원주의과대학 재활의학교실, 1비뇨기과학교실
Abstract

Objective
To evaluate the inhibition effects of hyper-reflexic detrusor activity by sacral afferent nerve stimulation in spinal cord injury (SCI) patients.


Method
The subjects were thirteen patients with SCI who had symptoms of urinary incontinence, because of hyper-reflexic bladder contractions. According to the level and severity of injury, the patients were divided into groups of tetraplegia/paraplegia and complete/incomplete. We applied dorsal penile nerve (DPN) stimulation using portable stimulator during the continuous bladder filling. Stimulation parameters were biphasic rectangular pulses of 25 Hz frequency, 250 microseconds pulse width. Stimulation intensity was twice the threshold of pudendo-anal reflex. The one minute stimulation was repeated to every reflex contraction during the cystometry. Immediate suppressive effect of DPN was analyzed.


Results
Of 13 patients who had a reflex bladder, hyper-reflexic detrusor contractions were suppressed effectively in 12 by DPN stimulation. The suppressive effect in groups of level and severity was not statistically significant.


Conclusion
DPN stimulation for inhibition of hyper-reflexic bladder contraction is an adjunctive method of incontinence management in SCI patients of different level and severity.

Key Words: Incontinence, Neurogenic bladder, Dorsal penile nerve stimulation


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