[Electrostimulation in treatment of neurogenic and non-neurogenic voiding dysfunction]

The efficiency of transcutaneous and intravesical temporary electrostimulation were evaluated in patients with neurogenic and non-neurogenic voiding dysfunction. Non-invasive electrostimulation was performed in 42 children with voiding dysfunction, at the age of 4 months to 15 years. In 5 children rectal electrode and impulse frequency of 50 Hz was used because of incompetent urethral function. In 9 children with detrusor overactivity rectal electrode and impulse frequency of 5 Hz was used. In 12 girls with discoordinated voiding electrostimulation with rectal electrode was used in biofeedback training. In one case intravesical electrostimulation was used in a girl with lazy bladder syndrome. In 15 patients with neurogenic voiding dysfunction intravesical electrostimulation was used to improve bladder sensation. The efficiency of the treatment was evaluated on the base of urodynamic investigation and patients' observations. The improvement was observed in 3 children from the group with urethral incompetence, both in urodynamic parameters and subjective patients' observations. One girl claimed no change in continence despite improvement in cystometric and profilometric testing. In one girl no change in urodynamic evaluation and continence was observed. Good results were observed in the group of 9 girls in which electrostimulation with rectal electrode was a part of the biofeedback training in discoordinated voiding. In the group of 9 children in whom electrostimulation with rectal electrode was used because of detrusor overactivity in 5 cases improvement in cystometric capacity was estimated. The estimation of usefulness of the intravesical electrostimulation in patients with neurogenic voiding dysfunction is not possible because of too short time of observation and the age of patients. We had to stop stimulation with rectal electrode in one patient because of inflammation of the skin in perineal region caused by cystitis. In two children stimulated with intravesical electrodes a new infection of urinary tract was observed.

1. Electrostimulation is a non-invasive, save method in the treatment of voiding dysfunction. 2. Electrostimulation with rectal electrodes is an effective method of treatment in cases of urethral incompetence, and an alternative method of treatment for detrusor overactivity. 3. Electrostimulation with rectal electrodes is an additional tool in biofeedback training of discoordinated voiding.