Dorsal column stimulation in multiple sclerosis: effects on bladder, leg blood flow and peptides

9 patients with bladder disorder secondary to multiple sclerosis (MS) were treated by dorsal column stimulation (DCS). Detailed urodynamic tests were performed and leg blood flow was assessed on repeated occasions. Cerebrospinal fluid (CSF) met-enkephalin levels were estimated before and during DCS. The chief effect of DCS was improved urinary flow associated with reduced sphincter tone and lessened detrusor instability maximal at the 6th or 7th day of continuous stimulation. Considerable fluctuation in leg blood flow occurred unrelated to activation of the stimulator. No obvious change in CSF met-enkephalin levels took place, but it is suspected that the mode of action of DCS in via certain peptide hormones.