Electrical stimulation of the pudendal nerve for neurogenic bladder dysfunction after spinal cord injury：a literature research on functional reconstruction / 中国组织工程研究

ABSTRACT

BACKGROUND:Stimulation of the pudendal nerve as a target can improve neurogenic bladder dysfunction after spinal cord injury, by adjusting the frequency, intensity, pulse width, as wel as regulating synergistic effect of detrusor and urethral sphincter. OBJECTIVE: To assess the research status of electrical stimulation of the pudendal nerve in the treatment of neurogenic bladder dysfunction after spinal cord injury. METHODS: We searched the folowing databases for articles addressing electrical stimulation of the pudendal nerve for neurogenic bladder dysfunction after spinal cord injury PubMed, Cochrane Central Register of Controled Trials (CENTRAL), China National Knowledge Infrastructure, Wanfang Database, and VIP Database. The search was updated to July 2014, and the reference lists of the identified studies were manualy screened for additional studies. The study selection and data extraction were independently conducted by two reviewers. RESULTS AND CONCLUSION:Fourteen studies were included in this review. We derived the folowing points by analyzing the included studies Electrical stimulation of the pudendal nerve has positive effects on rehabilitation of neurogenic bladder dysfunction after spinal cord injury; pudendal nerve electrical stimulation can modulate the coordination of the detrusor and the external urethral sphincter, improve the bladder compliance and restore bladder function by regulating pudendal-to-bladder reflex and spinal reflexes to the bladder. Electrical stimulation of the pudendal nerve may be potentialy implemented as a feasible treatment of neurogenic bladder dysfunction after spinal cord injury. More high quality researches should be conducted to clarify the efficacy and the potential active mechanisms of pudendal nerve electrical stimulation for neurogenic bladder dysfunction after spinal cord injury because the number of clinical reports published in this study area is limited, neurophysiological mechanisms underlying biphasic regulation of frequency on bladder function are not wel known, and which intensity of pudendal nerve electrical stimulation is more effective than others for the treatment of neurogenic bladder dysfunction after spinal cord injury remains unknown.