The role of electrical stimulation in the management of lower urinary track dysfunction following spinal cord lesions

  • Nikolaos Koutsogeorgis
  • Maria-Eleftheria Evangelopoulos
Keywords: Urinary track dysfunction, spinal cord injuries


Spinal cord lesions are traumatic or non-traumatic. Spinal cord injuries (SCI) may be complete or incomplete and lead to lower urinary track dysfunction (LUTD) in 95%. Multiple sclerosis is the most frequent cause of non-traumatic spinal cord lesions and leads to LUTD in more than 90% of patients 10 years after diagnosis. LUTD usually presents as neurogenic detrusor overactivity and/or detrusor-sphincter dyssynergia where oral medication is considered to be the first line of treatment and intravesical onabotulinum toxin injections the second, but there are side-effects and refractory cases. In addition, LUTD may present as detrusor underactivity where the above treatment options are not effective.
Clearly there is a need for a third line of treatment. In this review, we discuss the feasibility, safety and efficacy of electrical stimulation for the management of neurogenic LUTD, spanning from historic clinical to recent pre-clinical approaches. Neurostimulation methods are used on complete SCI patients, while neuromodulation methods are mostly used on incomplete spinal lesion patients and can be invasive or non-invasive. There is evidence that neuromodulation inhibits the development of neurogenic LUTD when applied shortly after acute spinal cord lesions. More high-quality studies are needed to prove efficacy of neuromodulation on neurogenic LUTD.


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