Treatment of unstable bladder

We present our experience with 2 spinal-injury patients tested for urinary incontinence via implanted sacral nerve electrodes. In each patient, spinal injury occurred at the T-12 level, with presentation of spontaneous detrusor activity. Associated weakness of the voluntary sphincter mechanism was evident urodynamically. Neurostimulation via wire electrode in the S3 foramen produced good sphincter closure. Voiding secondary to spontaneous detrusor triggering could thereby be suppressed, eliminating embarrassing incontinence without interfering with the patient's ability to empty the bladder at regular intervals. The therapeutic principles of neurostimulation applicable to patients with spastic bladders are underscored by these 2 cases.