Efficacy in Using Urodynamic Parameters of Intravesical Electrical Stimulation for Detrusor Underactivity

Area of Science:

• Urology
• Neuroscience
• Medical Devices

Background:

• Detrusor underactivity (DUA) presents a significant challenge in urological practice.
• Intravesical electrical stimulation (IVES) is a therapeutic option with debated efficacy for DUA.

Purpose of the Study:

• To evaluate the efficacy of intravesical electrical stimulation (IVES) in patients diagnosed with detrusor underactivity (DUA).
• To assess changes in urodynamic parameters before and after IVES treatment.

Main Methods:

• IVES was administered using a specialized catheter with an integrated electrode and a suprapubic anode.
• Patients received 12 sessions over one month with specific parameters (20 mA, 20 Hz, 200 µs, 60 min).
• Urodynamic assessments were conducted pre-treatment and one month post-treatment.

Main Results:

• Significant improvements were observed in maximum flow rate (Qmax), post-void residual (PVR), and detrusor pressure at Qmax (PDet@Qmax) after IVES.
• Patients with DUA secondary to chronic obstruction (CO) and idiopathic DUA (Idio) showed the most pronounced urodynamic improvements.
• Specific parameters like Qmax, PVR, and PDet@Qmax demonstrated statistically significant changes in the CO and Idio groups.

Conclusions:

• Intravesical electrical stimulation (IVES) demonstrates a positive therapeutic effect in managing detrusor underactivity (DUA).
• The efficacy of IVES is particularly notable in patients with idiopathic DUA or DUA resulting from chronic obstruction.