BLADDER STIMULATION THERAPY IMPROVES BLADDER COMPLIANCE - RESULTS FROM A MULTIINSTITUTIONAL TRIAL

Purpose: We examined data from multiple institutions to determine whet her intravesical bladder stimulation therapy is effective in improving bladder compliance by increasing bladder capacity and lowering bladde r storage pressures. Materials and Methods: The charts of 568 patients from 11 institutions were evaluated. Of the 568 patients 335 had adeq uate and accurate pretreatment and posttreatment urodynamic studies, a nd were included in this study. A total of 155 patients was from Child ren's Memorial Hospital, while the remaining 180 were from 10 other in stitutions. Bladder capacity and bladder capacity pressure were determ ined for each patient before and after therapy. Results: Overall, 53% of patients had increased bladder capacity of 20% or greater after tre atment (average increase 105 cc), which represents a 63% increase from pretreatment values. This increase occurred in an average of 1.9 year s. Further analysis of this subset of patients revealed that in 90% in travesical storage pressures were decreased or maintained within a saf e range (less than 40 cm. water). Evaluation of patients who did not r espond to bladder stimulation with a 20% or greater increase in bladde r capacity revealed that they had nearly normal bladder capacity befor e therapy. When the data on bladder capacity and bladder capacity pres sure from Children's Memorial Hospital were compared to results from t he 10 other institutions, there were no appreciable differences. Concl usions: Bladder stimulation is effective in increasing bladder capacit y without significantly elevating storage pressure in a majority of pa tients. We conclude that this technique is safe and effective in impro ving bladder compliance, and that it is reproducible elsewhere.