Functional magnetic stimulations for the autonomous neurogenic bladder of patients with spinal injury

Ning ZHOU; Xiaolin HUANG; Xinhua DING

ABSTRACT

BACKGROUND:

The autonomous neurogenic bladder(ANB) is one of the common problems and difficulty in rehabilitation of patients with spine injury. Having the advantages of safety, non-invasion and no side-effects,functional magnetic stimulation(FMS) has been applied in central nervous system(CNS) neurotransmission, recovery from nervous exhaustion, bone healing, treatment of neural disorders and research of brain function, and so on. But the studies on treatment of ANB after spine injury are not as profound and systematic as they were needed.

OBJECTIVE:

To investigate the therapeutic effect of FMS in patients with ANB caused by spine injury.

DESIGN:

A longitudinal observation based on patients.

SETTING:

Department of Rehabilitative Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.

PARTICIPANTS:

From May 2003 to May 2004, 12 patients with ANB hospitalized in the Rehabilitative Medicine Department of Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology were selected, 9 were male and 3 were female.

METHODS:

By using MagLite FMS Devices(made by Dantec, Danmark),a FMS therapy was employed at the sacral 3(S3) nerve root region and the bladder region, twice a day, 5 days a week, and a duration of 4 - 8 weeks.MAIN OUTCOME

MEASURES:

The pre-and post-treatment dynamics of urine flow variables(such as, residual urine volume, maximum urethral closure pressure(MUCP), the maximum bladder capacity, the bladder pressure, and the maximum urine flow rate), the frequency of urination, the average daily amount of urine, the maximum urine volume(V max), influence of urinary symptoms on the quality of life scale and the symptom score of lower urinary tract syndrome(LUTS) were selected as main outcomes measurements.

RESULTS:

Nearly all of the pre-and post-treatment dynamics of urine flow variables(such as, residual urine volume, MUCP, the maximum bladder capacity, the bladder pressure and the maximum urine flow rate) exhibited significant difference( P ＜ 0. 01 - 0. 001 ), except for the bladder pressure ( P ＞ 0.05); After FMS therapy, the frequency of urination decreased and the daily amount of urine and the V max increased significantly(P ＜ 0.01-0. 001); Also, the influence of urinary symptoms on the quality of life scale and the symptom score of LUTS changed significantly( P ＜ 0. 001 ).

CONCLUSION:

FMS therapy can greatly and partly ameliorate the bladder function of the patients with ANB after spine injury, and it can also improve their quality of life significantly.