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Dorsal Genital Nerve Stimulation in Patients with Detrusor Overactivity: A Systematic Review

  • Voiding Dysfunction and Lower Urinary Tract Symptoms (GH Badlani and HB Goldman, Section Editors)
  • Published:
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Abstract

This study evaluates the outcome of trials to stimulate the dorsal genital nerve (DGN) in patients with lower urinary tract dysfunction. The aim of most studies was to suppress detrusor overactivity in patients with overactive bladder (OAB) syndrome by DGN stimulation. A literature search was performed using Pub Med, Web of Science, and Scopus databases (1980 to April 2012) for clinical trials of DGN stimulation in patients with detrusor overactivity. Seventeen studies were found in the literature. In the studies, different patterns of DGN stimulation were applied. The patterns were either continuous, conditional, or semi-conditional; on an acute or on a chronic basis. DGN stimulation lead to improvement of bladder capacity and reduction in urgency and/or incontinence episodes in many patients. The outcomes of conditional stimulation were comparable to continuous stimulation with respect to improvement of bladder capacity. The publications give evidence that DGN stimulation increases bladder capacity and suppresses involuntary detrusor contractions. Implantable DGN stimulation electrodes can open the way for more prolonged studies in larger patient groups to assess the effectiveness of chronic DGN stimulation in patients with OAB syndrome. Chronic DGN stimulation seems to be of value in the management of OAB syndrome.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Shafik A, et al. Surgical anatomy of the pudendal nerve and its clinical implications. Clin Anat. 1995;8(2):110–5.

    Article  PubMed  CAS  Google Scholar 

  2. O'Bichere A, Green C, Phillips RKS. New, simple approach for maximal pudendal nerve exposure: anomalies and prospects for functional reconstruction. Dis Colon Rectum. 2000;43(7):956–60.

    Article  PubMed  Google Scholar 

  3. Yang CC, Bradley WE. Peripheral distribution of the human dorsal nerve of the penis. J Urol. 1998;159(6):1912–7.

    Article  PubMed  CAS  Google Scholar 

  4. Vaze A, et al. Determining the course of the dorsal nerve of the clitoris. Urology. 2008;72(5):1040–3.

    Article  PubMed  Google Scholar 

  5. Irwin DE, et al. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50(6):1306–14.

    Article  PubMed  Google Scholar 

  6. Abrams P, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation sub-committee of the International Continence Society. Urology. 2003;61(1):37–49.

    Article  PubMed  Google Scholar 

  7. Nakamura M, Sakurai T. Bladder inhibition by penile electrical stimulation. Br J Urol. 1984;56(4):413–5.

    Article  PubMed  CAS  Google Scholar 

  8. Vodusek DB, Light JK, Libby JM. Detrusor inhibition induced by stimulation of pudendal nerve afferents. Neurourol Urodyn. 1986;5(4):381–9.

    Article  Google Scholar 

  9. Prévinaire JG. Short-term effect of pudendal nerve electrical stimulation on detrusor hyperreflexia in spinal cord injury patients: Importance of current strength. Spinal Cord. 1996;34(2):95–9.

    Article  Google Scholar 

  10. Prévinaire JG, Soler JM, Perrigot M. Is there a place for pudendal nerve maximal electrical stimulation for the treatment of detrusor hyperreflexia in spinal cord injury patients? Spinal Cord. 1998;36(2):100–3.

    Article  PubMed  Google Scholar 

  11. Kirkham APS, et al. The acute effects of continuous and conditional neuromodulation on the bladder in spinal cord injury. Spinal Cord. 2001;39(8):420–8.

    Article  PubMed  CAS  Google Scholar 

  12. Dalmose AL, et al. Conditional stimulatzion of the dorsal penile/clitoral nerve may increase cystometric capacity in patients with spinal cord injury. Neurourol Urodyn. 2003;22(2):130–7.

    Article  PubMed  CAS  Google Scholar 

  13. Oliver S, et al. Measuring the sensations of urge and bladder filling during cystometry in urge incontinence and the effects of neuromodulation. Neurourol Urodyn. 2003;22(1):7–15.

    Article  PubMed  Google Scholar 

  14. Hansen J, et al. Treatment of neurogenic detrusor overactivity in spinal cord injured patients by conditional electrical stimulation. J Urol. 2005;173(6):2035–9.

    Article  PubMed  CAS  Google Scholar 

  15. Lee YH, Lee IS, Lee JY. Percutaneous electrical stimulation of sensory nerve fibers to improve motor function: Applications in voiding dysfunction. Curr Appl Phys. 2005;5(5):542–5.

    Article  Google Scholar 

  16. Fjorback MV, et al. Event driven electrical stimulation of the dorsal penile/clitoral nerve for management of neurogenic detrusor overactivity in multiple sclerosis. Neurourol Urodyn. 2006;25(4):349–55.

    Article  PubMed  Google Scholar 

  17. •• Goldman HB, et al. Dorsal genital nerve stimulation for the treatment of overactive bladder symptoms. Neurourol Urodyn. 2008;27(6):499–503. First, well designed, trial on a large patient group to test the continuous DGN stimulation in a chronic, home-based setting.

    Article  PubMed  Google Scholar 

  18. Opisso E, et al. Patient controlled versus automatic stimulation of pudendal nerve afferents to treat neurogenic detrusor overactivity. J Urol. 2008;180(4):1403–8.

    Article  PubMed  CAS  Google Scholar 

  19. Horvath EE, et al. Conditional and continuous electrical stimulation increase cystometric capacity in persons with spinal cord injury. Neurourol Urodyn. 2010;29(3):401–7.

    PubMed  Google Scholar 

  20. • Martens FMJ, Heesakkers JPFA, Rijkhoff NJM. Minimal invasive electrode implantation for conditional stimulation of the dorsal genital nerve in neurogenic detrusor overactivity. Spinal Cord. 2011;49(4):566–72. This study makes it potentially possible to develop an implantable needle electrode prototype.

    Article  PubMed  CAS  Google Scholar 

  21. Wheeler Jr JS, Walter JS, Sibley P. Management of incontinent SCI patients with penile stimulation: preliminary results. J Am Paraplegia Soc. 1994;17(2):55–9.

    PubMed  Google Scholar 

  22. •• Lee Y, Kim SH, et al. The effect of semiconditional dorsal penile nerve electrical stimulation on capacity and compliance of the bladder with deformity in spinal cord injury patients: a pilot study. Spinal Cord. 2012;50(4):289–93. Semi-conditional DGN stimulation may provide a solution for the shortcomings of both continuous and conditional stimulation.

    Article  PubMed  Google Scholar 

  23. Lee YH, Creasey GH. Self-controlled dorsal penile nerve stimulation to inhibit bladder hyperreflexia in incomplete spinal cord injury: a case report. Arch Phys Med Rehabil. 2002;83(2):273–7.

    Article  PubMed  Google Scholar 

  24. • Melgaard J, Rijkhoff NJ. Detecting the onset of urinary bladder contractions using an implantable pressure sensor. IEEE Trans Neural Syst Rehabil Eng. 2011;19(6):700–8. An implantable pressure sensor can be combined with an implantable DGN stimulation electrode in future practice.

    Article  PubMed  CAS  Google Scholar 

  25. Hansen J, et al. Urethral sphincter EMG as event detector for neurogenic detrusor overactivity. IEEE Trans Biomed Eng. 2007;54(7):1212–9.

    Article  PubMed  Google Scholar 

  26. Martens FMJ, Heesakkers JPFA, Rijkhoff NJM. Surgical access for electrical stimulation of the pudendal and dorsal genital nerves in the overactive bladder: a review. J Urol. 2011;186(3):798–804.

    Article  PubMed  Google Scholar 

  27. Worsoe J, Fynne L, et al. Electrical stimulation of the dorsal clitoral nerve reduces incontinence episodes in idiopathic faecal incontinent patients: a pilot study. Colorectal Dis. 2012;14(3):349–55.

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Department of Urology, Radboud University Nijmegen Medical Centre, Geert Grooteplein zuid 10, route 659, 6500 HB, Nijmegen, the Netherlands

    Fawzy F. Farag, Frank M. J. Martens & John P. F. A. Heesakkers

  2. Center for Sensory Motor Interaction (SMI), Aalborg University, Aalborg, Denmark

    Nico J. M. Rijkhoff

  3. Department of Urology, Sohag University Hospital, Sohag, Egypt

    Fawzy F. Farag

Authors
  1. Fawzy F. Farag
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  2. Frank M. J. Martens
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  3. Nico J. M. Rijkhoff
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  4. John P. F. A. Heesakkers
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Correspondence to Fawzy F. Farag.

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Farag, F.F., Martens, F.M.J., Rijkhoff, N.J.M. et al. Dorsal Genital Nerve Stimulation in Patients with Detrusor Overactivity: A Systematic Review. Curr Urol Rep 13, 385–388 (2012). https://doi.org/10.1007/s11934-012-0273-x

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  • DOI: https://doi.org/10.1007/s11934-012-0273-x

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