Genital nerve stimulation increases bladder capacity after SCI: A meta-analysis
Genital nerve stimulation increases bladder capacity after SCI: A meta-analysis
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DOI：
10.1080/10790268.2017.1281372
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发表时间：
2018-01-01
影响因子：
1.7
通讯作者：
Gustafson, Kenneth J.
中科院分区：
文献类型：
--
作者：
Bourbeau, Dennis J.;Creasey, Graham H.;Gustafson, Kenneth J.
背景：神经源性逼尿肌过度活动（NDO）通常会导致膀胱容量下降、尿失禁和膀胱输尿管反流。 NDO 会引发自主神经反射障碍，并会损害生活质量。生殖器神经 (GNS) 的电刺激可急剧抑制反射性膀胱收缩，并可增加膀胱容量。量化 GNS 对膀胱容量的影响并确定哪些研究因素和受试者因素影响膀胱容量的改善将为临床 GNS 干预措施的设计提供信息。方法：我们测量了 33 名患有 NDO 的个体（无论是否患有 GNS）的膀胱容量。这些数据与之前七项 GNS 研究（n=64 名受试者）的数据相结合。对膀胱容量的增加和潜在的实验因素进行了荟萃分析（总共 n = 97 名受试者）。结果：所有研究中，GNS 使受试者的膀胱容量增加了 131 +/- 101 ml。使用 GNS 后，膀胱容量大于 300 毫升的人数从 24% 增加到 62%。刺激幅度是预测膀胱容量增加的重要因素。膀胱容量增益的方差随着输注速率的增加而显着增加。其他因素不会导致膀胱容量增加。结论：GNS 会急剧增加 NDO 患者的膀胱容量。八项研究中膀胱容量的持续增加，以及不依赖于个体特定因素，使人们相信 GNS 可能成为许多 NDO 患者的有效工具。需要通过尿失禁等临床措施来研究 GNS 对膀胱控制的慢性影响。
Background: Neurogenic detrusor overactivity (NDO) often results in decreased bladder capacity, urinary incontinence, and vesico-ureteral reflux. NDO can trigger autonomic dysreflexia and can impair quality of life. Electrical stimulation of the genital nerves (GNS) acutely inhibits reflex bladder contractions and can increase bladder capacity. Quantifying the effect of GNS on bladder capacity and determining what study factors and subject factors influence bladder capacity improvements will inform the design of clinical GNS interventions.Methods: We measured bladder capacity in 33 individuals with NDO, with and without GNS. These data were combined with data from seven previous GNS studies (n=64 subjects). A meta-analysis of the increase in bladder capacity and potential experimental factors was conducted (n =97 subjects total).Results: Bladder capacity increased 131 +/- 101 ml with GNS across subjects in all studies. The number of individuals whose bladder capacity was greater than 300 ml increased from 24% to 62% with GNS. Stimulus amplitude was a significant factor predicting bladder capacity gain. The variance of the bladder capacity gain significantly increased with increasing infusion rate. Other factors did not contribute to bladder capacity gain.Conclusion: GNS acutely increases bladder capacity in individuals with NDO. The consistent increase in magnitude of bladder capacities across the eight studies, and the lack of dependence on individual-specific factors, provide confidence that GNS could be an effective tool for many individuals with NDO. Studies of the chronic effect of GNS on bladder control, with clinical measures such as urinary continence, are needed.