Pd59-11 a Novel Wearable Device for Dorsal Genital Neuromodulation in Controlling Neurogenic Detrusor Over-Activity in People With Spinal Cord Injury

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Neuromodulation (PD59)1 May 2024PD59-11 A NOVEL WEARABLE DEVICE FOR DORSAL GENITAL NEUROMODULATION IN CONTROLLING NEUROGENIC DETRUSOR OVER-ACTIVITY IN PEOPLE WITH SPINAL CORD INJURY Richard P. Nobrega, Sarah L. Knight, Sean P. Doherty, Evangeline Martinez, and Lynsey Duffell Richard P. NobregaRichard P. Nobrega , Sarah L. KnightSarah L. Knight , Sean P. DohertySean P. Doherty , Evangeline MartinezEvangeline Martinez , and Lynsey DuffellLynsey Duffell View All Author Informationhttps://doi.org/10.1097/01.JU.0001009544.34256.8a.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Neurogenic detrusor over-activity (NDO) can cause incontinence and potential damage to the upper tracts in people with spinal cord injury (SCI). It is normally controlled with anti-muscarinic medication or intra-detrusor botulinum toxin injections, which can have side effects. Neuromodulation of the pudendal nerve has been shown to increase bladder capacity and reduce pressures. We have investigated the effectiveness of an investigational wearable dorsal genital nerve stimulation (DGNS) device in controlling NDO in people with SCI over an 8 week period. METHODS: People with urodynamically proven NDO following SCI were invited to participate and gave informed consent. Baseline bladder diaries and questionnaires were completed. Urodynamics were performed with 4 filling cycles: a control, with DGNS initiated by investigator when pressure exceeded 10 cmH2O, with DGNS initiated by participant based on sensation and a final control. Maximum cystometric capacity (MCC) and maximum detrusor pressure (MDP) were recorded. DGNS was applied through a novel wearable device with cathode located on dorsum of penis or adjacent to clitoris and anode placed on thigh. DGNS was applied at 20 pps, 200 mcs pulse width and minimum current based on threshold for pudendo-anal reflex. Participants used the device at home for an 8 week period and then returned for further urodynamics cycles. A final set of urodynamics was conducted 4 weeks post-intervention. RESULTS: 11 participants with SCI were recruited (average age 48.4 years (range 26-65) and average time since injury 9 years (range 1-29). At baseline visit, control MCC was 201±139 ml which was significantly increased to 373±136 ml with DGNS (n=11). 5 participants have completed the full trial; MCC and MDP during control (solid line) and DGNS (dashed line) fills at each visit are shown in Figure 1. Control MCC was increased after 8 weeks, but this returned to baseline after intervention. CONCLUSIONS: We have demonstrated that DGNS through an investigational wearable device can increase bladder capacity and reduce MDP and provide an alternative to management of NDO following SCI. Download PPT Source of Funding: RNOH CharityINSPIRE Foundation © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1225 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Richard P. Nobrega More articles by this author Sarah L. Knight More articles by this author Sean P. Doherty More articles by this author Evangeline Martinez More articles by this author Lynsey Duffell More articles by this author Expand All Advertisement PDF downloadLoading ...