Self-controlled dorsal penile nerve stimulation to inhibit bladder hyperreflexia in incomplete spinal cord injury: A case report
Self-controlled dorsal penile nerve stimulation to inhibit bladder hyperreflexia in incomplete spinal cord injury: A case report
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DOI：
10.1053/apmr.2002.28817
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发表时间：
2002-02-01
影响因子：
4.3
通讯作者：
Creasey, GH
中科院分区：
文献类型：
--
作者：
Lee, YH;Creasey, GH
间歇性导管插入术在脊髓损伤（SCI）中并不总是成功的，并且通常需要采用其他方法。电刺激骶传入神经可减少膀胱过度活动。本报告描述了自控阴茎背神经刺激治疗不完全性脊髓损伤的膀胱反射亢进。患者为一名33岁男性，C6不完全性四肢瘫痪，通过间歇性自我导尿和药物治疗膀胱。尽管如此，他仍然有反射性膀胱收缩，他能感觉到，但无法及时导尿以防止尿失禁。我们用阴茎背神经刺激进行膀胱测压，并分析家庭使用刺激的数据。膀胱测压时，电刺激对反射亢进收缩的抑制作用可靠且可重复。患者可在感觉到膀胱收缩时开始刺激，停止短暂刺激后，反射性收缩抑制持续数分钟。当在家中使用刺激时，导管插入之间的泄漏率降低，导管插入量显著增加。
Intermittent catheterization is not always successful in achieving continence in spinal cord injury (SCI) and often requires adjunctive methods. Electric stimulation,of sacral afferent nerves reduces hyperactivity of the bladder. This report describes application of self-controlled dorsal penile nerve stimulation for bladder hyperreflexia in incomplete SCI. The patient was a 33-year-old man with C6 incomplete quadriplegia who managed his bladder with intermittent self-catheterization and medication. Despite this, he continued to have reflex bladder contractions that he could feel but could not catheterize himself in time to prevent incontinence. We performed cystometry with dorsal penile nerve stimulation and analyzed data of home use of stimulation. During cystometry, the suppressive effect of electric stimulation on hyperreflexic contractions was reliable and reproducible. The patient could start stimulation on sensing bladder contraction, and the suppression of reflex contraction lasted several minutes after stopping brief stimulation. When using stimulation at home, the rate of leakage between catheterization decreased, and catheterized volume increased significantly.