Neuromodulation of detrusor hyper-reflexia by functional magnetic stimulation of the sacral roots
Version of Record online: 29 OCT 2003
British Journal of Urology
Volume 78, Issue 1, pages 39–46, July 1996
How to Cite
Sheriff, M.K.M., Shah, P.J.R., Fowler, C., Mundy, A.R. and Craggs, M.D. (1996), Neuromodulation of detrusor hyper-reflexia by functional magnetic stimulation of the sacral roots. British Journal of Urology, 78: 39–46. doi: 10.1046/j.1464-410X.1996.00358.x
- Issue online: 29 OCT 2003
- Version of Record online: 29 OCT 2003
- Cited By
- Detrusor hyper-reflexia;
- functional magnetic stimulation
Objective To investigate the acute effects of functional magnetic stimulation (FMS) on detrusor hyper-reflexia using a multi-pulse magnetic stimulator.
Patients and methods Seven male patients with established and intractable detrusor hyper-reflexia following spinal cord injury were studied. No patient was on medication and none had had previous surgery for detrusor hyper-reflexia. After optimization of magnetic stimulation of S2–S4 sacral anterior roots by recording toe flexor electromyograms, unstable detrusor activity was provoked during cystometry by rapid infusion of fluid into the bladder. The provocation test produced consistent and predictable detrusor hyper-reflexia. On some provocations, supramaximal FMS at 20 pulses/s for 5 s was applied at detrusor pressures which were >15 cmH20.
Results Following FMS there was an obvious acute suppression of detrusor hyper-reflexia. There was a profound reduction in detrusor contraction, as assessed by the area under the curves of detrusor pressure with time.
Conclusions Functional magnetic stimulation applied over the sacrum can profoundly suppress detrusor hyper-reflexia in man. It may provide a non-invasive method of assessing patients for implantable electrical neuromodulation devices and as a therapeutic option in its own right.