TRANSURETHRAL ELECTRICAL BLADDER STIMULATION - A FOLLOW-UP REPORT

Transurethral electrical bladder stimulation (TEBS) initially proposed to rehabilitate the neurogenic bladder has been promoted in the Unite d States since the mid 1980s. The ultimate goal of TEBS is volitional voiding. Since January 1989 we performed 938 sessions of stimulation c omprising 64 TEBS series in 25 patients with neurogenic bladders. A cy stometrogram was performed before each series of stimulation to monito r progress, and at the time of this review parental impressions of the stimulation were obtained by a telephone interview questionnaire. The initial evaluation cystometrogram before stimulation revealed that 18 patients (72%) had bladder contractions. After TEBS 24 patients (96%) manifest contractions. Before stimulation only 3 children sensed the contractions, while during stimulation half of the patients perceived the contractions. A cystometrogram performed before each series demons trated a greater than 20% increase in the age adjusted bladder capacit y in 6 of the 18 patients (33%) with serial studies. Improvements in t he end filling pressure defined by clinically significant decreases we re observed in 5 of these patients (28%). Results of the telephone que stionnaire revealed that the parents perceived a benefit from stimulat ion more often than the urodynamic studies could confirm. In our exper ience TEBS is a time-consuming, labor intensive technique. The limited urodynamic benefits our patients achieved have not materially altered the daily voiding regimen and, because of these factors, we are not e nrolling any new patients in our TEBS program.