[Effects of peripheral functional electrostimulation in obstructive bladder instability].

Abstract

INTRODUCTION: The aim of this study was to assess the effects of peripheral functional electrical stimulation (FES) in patients with detrusor instability (DI) secondary to obstructive Benign Prostatic Hyperplasia (BPH). SUBJECTS, MATERIAL & METHODS: Nine patients with urodynamically proven DI secondary to BPH were investigated. Sensory and pudendo-anal reflex thresholds were determined in each patient to individually optimise FES. A standard fill cystometry was then performed and individually optimised FES was given when an unstable detrusor contraction occurred. Non stimulated contractions were used as controls. The effects of FES were analysed by measuring the mean area under the unstable pressure curves with and without FES and were expressed as percentage suppression. RESULTS: The percentage suppression in the mean area under the curves after stimulation was < 10%. There was no statistically significant difference between controls and FES using a two tailed, paired students t-Test (p > 0.1) at 95% confidence level (p > or = 0.05). CONCLUSION: FES did not significantly suppress unstable bladder contractions in patients with DI secondary to BPH. This finding suggests that obstructive DI does not depend on sacral reflex mechanisms and supports the view that it has a peripheral pathophysiological origin (myogenic and/or nerve endings).