TRANSCUTANEOUS ELECTRICAL-STIMULATION OF THIGH MUSCLES IN THE TREATMENT OF DETRUSOR OVERACTIVITY

Objective To investigate the clinical effects on detrusor overactivity of a new method of transcutaneous reciprocal electrical stimulation o f the thigh muscles. Patients and methods Nineteen patients with detru sor overactivity, comprising 14 with detrusor hyperreflexia (DH! and f ive with idiopathic detrusor instability (IDI), were studied. Electric al stimulation was applied alternately to the quadriceps and hamstring muscles of one or both legs through surface electrodes for 20 min. Th e treatment was given once a day for 14 days and then the patients wer e evaluated urodynamically. Results All 19 patients tolerated the ther apy well and none reported any adverse effects. The mean maximum cysto metric capacity increased significantly (P<0.05) after treatment. In 1 1 of the 19 patients, the maximum cystometric capacity was increased b y >50% of the pretreatment value; this occurred in eight of 14 of thos e with DH and in three of ave of those with IDL. In six of the 11 who responded in this way, there was a clinical improvement in their urina ry incontinence and frequency for several weeks to 3 months after the period of therapy. A second 14-day treatment was also effective in all four patients who underwent a repeat trial, Conclusion This method of transcutaneous electrical stimulation can inhibit DH as well as IDI w ith no adverse effects, The suppressive effect on detrusor overactivit y may persist for several months and repeat trials appear to be effect ive, Thus, we believe that this new stimulation technique should be tr ied as an alternative to other types of electrical stimulation and aug mentation cystoplasty.