A URODYNAMIC STUDY OF SURFACE NEUROMODULATION VERSUS SHAM IN DETRUSORINSTABILITY AND SENSORY URGENCY

Purpose: We studied the effect of surface neuromodulation on cystometr ic pressure and volume parameters in women with detrusor instability o r sensory urgency. Electrical current was delivered to the suprapubic region and third sacral foramina via a transcutaneous electrical nerve stimulator with sham neuromodulation control. Materials and Methods: A consecutive series of women with proved detrusor instability or sens ory urgency were randomized to 3 surface neuromodulation groups. Volum e and pressure parameters were the main outcomes of transcutaneous ele ctrical nerve stimulation applied during second cystometric fill. Resu lts: Sham transcutaneous electrical nerve stimulation did not alter th e outcome measures. However, neuromodulation delivered across the supr apubic and sacral skin effected a reduction in mean maximum height of detrusor contraction. A current which inhibits motor activity was not superior to that which inhibits sensory perception in reducing detruso r pressure. Response in sensory urgency was poor. Conclusions: Results from our sham controlled study suggest that short-term surface neurom odulation via transcutaneous electrical nerve stimulation may have a r ole in the treatment of detrusor instability. Future studies must exam ine the clinical effect of long-term surface neuromodulation.