Lower abdominal pressure versus external bladder stimulation to aid bladder emptying in multiple sclerosis: a...

Area of Science:

• Neuro-urology
• Rehabilitation Medicine
• Medical Device Technology

Background:

• Multiple sclerosis (MS) frequently causes urinary dysfunction, including elevated post-void residual bladder volumes (PVR).
• Managing PVR is crucial for preventing complications and improving quality of life in MS patients.

Purpose of the Study:

• To evaluate the efficacy of abdominal vibration using a percutaneous bladder stimulator in reducing PVR in MS patients.
• To compare abdominal vibration with abdominal pressure and no treatment for PVR reduction.

Main Methods:

• A randomized controlled cross-over study involving 28 MS patients with PVR > 100 ml.
• Patients were randomized to receive abdominal vibration, abdominal pressure, or no treatment over two-week phases.
• Post-void residual bladder volumes were measured using ultrasound at the end of each phase.

Main Results:

• Suprapubic vibration significantly reduced PVR from 231 ml (no treatment) to 126 ml (p = 0.002).
• Abdominal pressure showed a non-significant reduction in PVR (191 ml, p = 0.242) compared to no treatment.
• The difference between vibration and abdominal pressure approached significance (p = 0.059).

Conclusions:

• Abdominal vibration is an effective intervention for decreasing PVR in patients with multiple sclerosis.
• Percutaneous suprapubic vibration demonstrates superior efficacy over abdominal pressure alone in managing urinary retention in MS.