Ann Rehabil Med.  2015 Oct;39(5):718-725. 10.5535/arm.2015.39.5.718.

Short-Term Effect of Percutaneous Bipolar Continuous Radiofrequency on Sacral Nerves in Patients Treated for Neurogenic Detrusor Overactivity After Spinal Cord Injury: A Randomized Controlled Feasibility Study

• Kim JH
• Ahn SH
• Cho YW
• Kwak SG
• Kim HS

• KMID: 2148202
• DOI: http://doi.org/10.5535/arm.2015.39.5.718

Abstract

OBJECTIVE
To investigate the short-term effects of bipolar radiofrequency applied to sacral nerves to treat neurogenic detrusor overactivity in patients with spinal cord injury.
METHODS
Ten patients with spinal cord injury with neurogenic detrusor overactivity were recruited. These subjects were randomized to two groups: intervention (n=5) and control (n=5), members of which received conventional treatment. Voiding diary, International Consultation on Incontinence Questionnaire (ICIQ) and the urinary incontinence quality of life scale (IQOL) data were obtained and an urodynamic study (UDS) was performed before and after intervention. In the intervention group, percutaneous bipolar continuous radiofrequency (CRF) was performed on both the S2 and S3 nerves in each patient.
RESULTS
In a comparison of daily frequency and number of urinary incontinence and ICIQ and IQOL scores at baseline and at 1 and 3 months after intervention, all variables achieved a significant effect for time (p<0.05). Regarding UDS parameters, pre/post intervention differences between baseline and 3-month post-intervention for volume at maximal detrusor pressure during filling and reflex detrusor volume at first contraction were significantly different between the two groups (p<0.05). However, pre/post intervention differences in maximum cystometric capacity and maximum detrusor pressure during filling were not significant between the two groups (p>0.05).
CONCLUSION
Percutaneous bipolar CRF applied to sacral nerves might be an effective therapy for neurogenic overactive bladder that reduces urinary incontinence and improves quality of life.

Keyword

Radiofrequency; Sacral nerves; Detrusor overactivity; Urinary incontinence; Maximal cystometric capacity

MeSH Terms

Feasibility Studies*
Humans
Quality of Life
Reflex
Spinal Cord Injuries*
Spinal Cord*
Urinary Bladder, Overactive
Urinary Incontinence
Urodynamics

Figure

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  Fig. 1 (A) The anteroposterior view of bipolar radiofrequency on the right S2 and S3 nerve roots. (B) The lateral view of bipolar radiofrequency on the right S2 and S3 nerve roots.

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  Fig. 2 A comparison of daily frequency and volume of urinary incontinence and ICIQ and IQOL scores at baseline and at 1 and 3 months after intervention. (A) Frequency of urinary incontinence, (B) volume of urinary incontinence, (C) ICIQ, and (D) IQOL. ICIQ, International Consultation on Incontinence Questionnaire; IQOL, urinary incontinence quality of life scale. Values are presented as mean (standard error).

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