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Vesical pacing in patients with overactive bladder: Technique and results

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Abstract

Objectives: A recent study has demonstrated that the electric activity of the overactive bladder (OAB) is `dysrhythmic'. The cause was attributed to a disordered vesical pacemaker which discharges these waves. In a subsequent study, the dysrhythmic waves have been `normalized' by vesical pacing and the optimal parameters which are required to achieve normalization have been defined. We investigated the hypothesis that vesical pacing of the OAB might improve not only the vesical electric activity but also the symptoms. Methods: Vesical pacing was used in 9 patients (age 39.2 ± 10.3; 5 women, 4 men) with OAB. Under anesthesia, the pacemaker was implanted in an inguinal subcutaneous pocket and connected to 2 pacing electrodes implanted into the vesical vault. The normalization of the waves was tested by 2 recording electrodes which were temporarily applied to the vesical wall and removed post-testing. The pacemaker was then programmed for home pacing to be activated at given times. Results: Vesical pacing effected normalization of the dysrhythmic electric waves with disappearance of the OAB symptoms in 7 patients and failed in 2. Vesical pacing was abandoned in 3/7 patients after a few months following the spontaneous disappearance of the symptoms. Conclusions: Vesical pacing has normalized the dysrhythmic electric activity and suppressed the symptoms of the OAB in 77.7% of patients. The pacemaker was removed in 5 patients: 2 failures and 3 after spontaneous waves normalization. No complications were encountered. Vesical pacing is suggested as a treatment for OAB when commonly used therapeutic modalities have failed.

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Authors and Affiliations

  1. 2 Talaat Harb Street, Cairo, 11121, Egypt

    Ahmed Shafik & Ali Shafik

  2. Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Cairo, Egypt

    Ahmed Shafik & Ismail Shafik

  3. Department of Surgery, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt

    Olfat El-Sibai

  4. Department of Physiology, Faculty of Medicine, Zagazig University, Benha, Egypt

    Randa M. Mostafa

Authors
  1. Ahmed Shafik
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  2. Ismail Shafik
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  3. Olfat El-Sibai
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  4. Ali Shafik
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  5. Randa M. Mostafa
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Correspondence to Ahmed Shafik.

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Shafik, A., Shafik, I., El-Sibai, O. et al. Vesical pacing in patients with overactive bladder: Technique and results. Int Urol Nephrol 36, 29–34 (2003). https://doi.org/10.1023/B:UROL.0000032674.57294.16

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  • DOI: https://doi.org/10.1023/B:UROL.0000032674.57294.16

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