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Summer 2018 Edition

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Bladder Neuromodulation with Surface Electric Stimulation in Acute Spinal Cord Injury

Argyrios Stampas, MD, and his research team recently concluded that transcutaneous tibial nerve stimulation (TTNS) can be performed safely to improve management of neurogenic bladder during inpatient rehabilitation of patients with acute traumatic spinal cord injury. “Most people with SCI have some degree of bladder impairment, which research has shown is the number-one priority for improvement in quality of life with SCI,” says Dr. Stampas, principal investigator, an attending physician in the Spinal Cord Injury Program at TIRR Memorial Hermann and a clinical assistant professor in the department of Physical Medicine and Rehabilitation at McGovern Medical School at UTHealth. “Treatment of neurogenic bladder involves the use of anticholinergic bladder medications, which have side effects that ultimately lead to non-compliance. Our evidence suggests that electric stimulation with TTNS can produce the same results without side effects.”

Nineteen traumatic SCI patients admitted to TIRR Memorial Hermann for acute inpatient rehabilitation consented to the study and completed the TTNS stimulation protocol. They were randomized to TTNS versus sham stimulation, and the principal investigator and participants were blinded to treatment allocation.

“Bladder capacity and episodes of detrusor sphincter dyssynergia (DSD) remained stable in the TTNS group compared to worsened findings in the sham group, suggesting that TTNS can alter the course of neurogenic bladder via neuromodulation,” Dr. Stampas says. “Morbidity was similar between the groups, and compliance to the TTNS protocol was 100 percent.”

Dr. Stampas’ research on bladder neuromodulation began with a TIRR Memorial Hermann Rehabilitation Innovation Grant and is supported by Mission Connect, a program of TIRR Foundation. “My long-term goal is to provide a more effective and safer treatment for neurogenic bladder that can be used from admission to rehabilitation to discharge to home,” he says. “We’re hopeful that TTNS can help patients reduce, if not completely discontinue, bladder medication and maintain a safe bladder.”

See the related article on “Home Neuromodulation of the Neurogenic Bladder in Chronic Spinal Cord Injury with Transcutaneous Tibial Nerve Stimulation” under TIRR Memorial Hermann Rehabilitation Innovation Awards. For more information on the study, contact Dr. Stampas at (713) 797-5938.

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