Genital bar electrode for dorsal genital nerve stimulation: feasibility and safety of a novel approach for managing bowel dysfunction and overactive bladder

BACKGROUND: Electrical stimulation of the dorsal genital nerve (DGN) using a patch electrode is effective in treating bowel dysfunction (BD) with faecal urgency and/or incontinence and overactive bladder (OAB). Keeping the patch electrode in place during stimulation may be challenging. This study evaluated the feasibility and safety of inserting a novel genital bar electrode for DGN stimulation. METHOD: A vertical clitoral hood piercing with a specially designed genital bar electrode was inserted under aseptic conditions with topical anaesthesia in women who had undergone DGN stimulation via a patch electrode, and reported subjective symptom improvement. After a 4-week healing period, stimulation with the bar electrode was initiated, followed by completion of a similar symptom diary to that with the patch electrode. RESULTS: All 14 patients included in the study completed it. No procedure-related complications occurred. During the healing period, 10 patients experienced minor transient adverse events: mild bleeding or pain (n = 7 each), swelling (n = 4), redness (n = 3), and isolated numbness, irritation, or itching (n = 1 each). Nine patients experienced stimulation-related adverse events, mainly local pain or discomfort. Granulation tissue developed in one case. Urgency and incontinence episodes were reduced by a median of 70% and 59%, respectively, during genital bar electrode stimulation, with symptom responses similar to those observed with patch electrode stimulation. CONCLUSION: Inserting a genital bar electrode is feasible and safe. Preliminary results indicate a symptom response comparable to patch electrode stimulation in the majority.