Nerve Stimulation/Neuromodulation In Treatment Of Neurogenic Bladder After Spinal Cord Injury(ReVIEW)

Neurogenic bladder is one of the common complications after spinal cord injury.Its treatment includes drug therapy,behavior therapy,surgical treatment,and nerve stimulation/neuromodulation which develops in recent years.This new technique’s experimental and clinical research at home and abroad has made some curative effect.Nerve stimulation/neuromodulation stimulates in different parameters directly or indirectly on different nerves, regulates the functions of the nerve,and promotes the production of effects from target organs to promote urination and improve the symptoms of neurogenic bladde.Different stimulation methods have advantages and disadvantages.The application of SARS is the most wide and mature.Intermittent stimulations in sacral anterior root of S2-S4 lead to post-stimulus voiding based on different contraction characteristic between smooth muscle and striated muscle.The result of SARS will be better combining with sacral deafferentation,however postoperative complications make people choose it with more caution. SNS/SNM stimulates afferent fibers of S2-S4 unremittingly to restore normal urine storage and elimination,but its effect on SCI patients needs more long-term research.PNS,whose stimulation parameter is similar to SNS, works on the pudendal nerve and its branches to cause detrusor contraction or relaxation.Its response relies upon current intensity and frequency.PNS has good flexibility and little complication,however more stable stimulation parameter and more samples of long-term curative effect are needed.PTNS may take effect by activating the nerve and then inhibiting overactive bladder.The disadvantage of this simple and easy way is a lack of treatment guidelines and maintain plan with unified standard.