RESTORATION OF MICTURITION IN PATIENTS WITH ACONTRACTILE AND HYPOCONTRACTILE DETRUSOR BY TRANSURETHRAL ELECTRICAL BLADDER STIMULATION

The aim of transurethral electrical bladder stimulation (TEES) treatme nt in patients with diminished detrusor contractility is to attain com plete voiding, i.e., micturition without residual urine, which is unde r volitional control. In contrast to other types of electrical bladder stimulation, the physiological basis for this kind of treatment is se nsitizing of the bladder mechanoreceptor afferents. The latency of aff erent stimuli in normal conditions indicates that myelinated A-delta-f ibers are used for neurotransmission from these mechanoreceptors. Fort y-eight patients with hypocontractile or acontractile detrusor underwe nt intravesical electrical stimulation. All patients had a history poi nting to neurogenic pathology. Forty patients had an acontractile and 8 a hypocontractile bladder. Prior to therapy, the mean residual urine volume was 461 ml. After stimulation, 32 of 48 patients were able to void with a mean residual of 57 ml. Detrusor contraction was achieved in 39% and bladder sensation was perceived by 75% of patients who fail ed these conditions before treatment. Following therapy, 19 of 35 pati ents were able to empty their bladder without the previously needed ca theterization. Side effects were epididymitis in 1 and cystitis in 7 p atients. (C) 1996 Wiley-Liss, Inc.