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Electrical stimulation in the treatment of bladder dysfunction: technology update.
R L Coolen1, J Groen1, Bfm Blok1
1Department of Urology, Erasmus Medical Center, Rotterdam 3015 GD, The Netherlands.
Medical Devices (Auckland, N.Z.)
|October 2, 2019
Summary
Sacral neurostimulation (SNM) offers a third-line treatment for overactive bladder (OAB) and underactive bladder (UAB). Rechargeable devices provide similar safety and effectiveness to non-rechargeable options, with recent MRI approvals.
Area of Science:
- Urology
- Neurology
- Biomedical Engineering
Background:
- Lower urinary tract symptoms (LUTS) include storage issues like incontinence and urgency (overactive bladder, OAB), and voiding issues like incomplete emptying (underactive bladder, UAB).
- Causes of OAB and UAB can be non-neurogenic (idiopathic) or neurogenic (e.g., spinal cord injury, multiple sclerosis).
- Conservative treatments (lifestyle, medication) are first-line, with electrical stimulation, specifically sacral neurostimulation (SNM), as a third-line option for non-neurogenic OAB/UAB.
Purpose of the Study:
- To review the role of sacral neurostimulation (SNM) as a third-line therapy for overactive bladder (OAB) and underactive bladder (UAB).
- To compare the safety and effectiveness of newly available rechargeable SNM devices with traditional non-rechargeable systems.
- To highlight recent advancements in SNM technology, including MRI compatibility.
Main Methods:
- Review of clinical applications and technological advancements in sacral neurostimulation (SNM) for lower urinary tract symptoms.
- Comparison of outcomes between non-rechargeable and rechargeable SNM systems.
- Discussion of MRI compatibility of the rechargeable SNM device.
Main Results:
- Sacral neurostimulation (SNM) is an established third-line therapy for refractory non-neurogenic overactive bladder (OAB) and underactive bladder (UAB).
- Rechargeable SNM systems demonstrate comparable safety and effectiveness to non-rechargeable systems.
- The rechargeable SNM device received European approval for full-body 1.5T and 3T MRI in February 2019.
Conclusions:
- Sacral neurostimulation (SNM) provides a valuable therapeutic option for patients with overactive bladder (OAB) and underactive bladder (UAB) unresponsive to conservative treatments.
- The advent of rechargeable SNM devices offers patients a comparable alternative to non-rechargeable systems, with enhanced features like MRI compatibility.
- Further research may explore the efficacy of electrical stimulation in specific neurogenic lower urinary tract dysfunction populations.
