Epidural spinal cord stimulation for the treatment of neurogenic bladder.

The effect of percutaneous epidural spinal cord stimulation on neurogenic bladder has been evaluated on the basis of objective clinical and urodynamic criteria. Seven patients suffering from stable bladder and sphincter dysfunction due to spinal cord diseases of different causes of non-evolutive nature were examined. In some of them chronic pain or substantially improved micturition in six of our seven patients. Complete or almost complete relief of bladder spasticity, marked increase of bladder capacity, and reduction or abolition of residual urine were recorded. The beneficial effect on bladder and sphincter function is strictly dependent on the stimulation, though it can outlast it. It requires some weeks to reach its maximum. It is still obtained after 22 months of treatment (longest present follow-up). No changes of straital activity and detrusor reflex were produced by spinal cord stimulation in two additional patients, treated for chronic pain but having intact bladder function.