Intravesical electrotherapy for neurogenic bladder dysfunction: a 22-year experience.

摘要

PURPOSE: Intravesical electrotherapy was previously shown to be effective for improving bladder capacity and compliance. We evaluated our 22-year experience with this therapy in patients with neurogenic bladder. MATERIALS AND METHODS: The charts of 405 patients who received intravesical electrotherapy were reviewed. Cystometrograms were performed at the start of each treatment series. Bladder capacity and pressure were determined for each patient before and after therapy. Patients were also questioned regarding the sensation of bladder filling. RESULTS: From 1985 to 2006, 372 patients with an average age of 5.5 years (range 0 to 43) had followup information available and were included for evaluation. Patients received a median of 29 treatment sessions (range 2 to 197). Mean patient followup was 6.6 years (range 0 to 19.7). Of the 372 patients 286 (76.9%) had a 20% or greater increase in bladder capacity after treatment. In this subset of patients bladder storage pressure at capacity was normal (less than 40 cm water) in 74.4% (213 of 286). Of the 17.2% of patients (64 of 372) who had no change in bladder capacity 81.21% (52 of 64) had normal bladder storage pressures after treatment. Bladder sensation was developed and sustained in 61.6% of patients (229 of 372), including 33.6% in the first series. CONCLUSIONS: Bladder stimulation is effective for increasing bladder capacity without increasing storage pressure in a majority of patients. This technique is safe and effective for improving bladder compliance. Some patients also have improved sensation of bladder filling and they should be able to catheterize when feeling full rather than by the clock.