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Neuromodulation for Non-obstructive Urinary Retention

  • C. R. Powell
Chapter

Abstract

Non-obstructive urinary retention in children and adults is distinct from classical urinary retention in that no anatomic cause for incomplete bladder emptying can be found. This poses unique challenges to treating clinicians, and until recently, management was limited to physical therapy, assisted emptying with intermittent catheterization, foley catheter placement, or urinary diversion. Neuromodulation, in multiple forms, offers a minimally invasive method to restore normal urinary function in some patients suffering from non-obstructive urinary retention. The techniques and evidence for this will be discussed. Sacral neuromodulation has garnered the most attention in the literature, but other forms of neuromodulation such as posterior tibial nerve stimulation, nerve re-routing, sacral anterior nerve stimulation, and emerging technologies incorporating biologic feedback also exist and show promise. The next decade promises more improvements for the treatment of non-obstructive urinary retention emphasizing the ability to void spontaneously. Neuromodulation techniques over the next decade may make it possible to reduce or eliminate the need for catheters and urinary diversion in these patients.

Keywords

Urinary retention Posterior tibial nerve stimulation Sacral neuromodulation Neuromodulator Urinary incontinence Neurostimulation Sacral nerve stimulation Peripheral nerve stimulation Urinary bladder, neurogenic Urinary frequency Urination Urination disorders Spinal cord injury Percutaneous nerve stimulation Detrusor underactivity 

References

  1. 1.
    Coyne KS, Sexton CC, Thompson CL, Milsom I, Irwin D, Kopp ZS, et al. The prevalence of lower urinary tract symptoms (LUTS) in the USA, the UK and Sweden: results from the Epidemiology of LUTS (EpiLUTS) study. BJU Int. 2009;104:352–60.CrossRefGoogle Scholar
  2. 2.
    Brasure M, Fink H, Risk M. Chronic urinary retention: comparative effectiveness and harms of treatments. In: Quality AfHRa, editor. Rockville, MD: Agency for Healthcare Research and Quality; 2014.Google Scholar
  3. 3.
    WIKI. Urinary Retention. ICS Wiki: International Continence Society; 2016.Google Scholar
  4. 4.
    Stoffel J, Lightner D, Peterson A, Sandhu J, Suskind A, Wei J. Non-neurogenic chronic urinary retention: consensus definition, management strategies, and future opportunities. AUA White Paper. Linthicum, MD: American Urological Association; 2016.Google Scholar
  5. 5.
    Lower urinary tract symptoms in men: management. United Kingdom: National Institute for Health and Care Excellence; 2015.Google Scholar
  6. 6.
    Oelke M, Speakman MJ, Desgrandchamps F, Mamoulakis C. Acute urinary retention rates in the general male population and in adult men with lower urinary tract symptoms participating in pharmacotherapy trials: a literature review. Urology. 2015;86:654–65.CrossRefGoogle Scholar
  7. 7.
    Kaplan SA, Wein AJ, Staskin DR, Roehrborn CG, Steers WD. Urinary retention and post-void residual urine in men: separating truth from tradition. J Urol. 2008;180:47–54.CrossRefGoogle Scholar
  8. 8.
    Lim CS, Abrams P. The Abrams-Griffiths nomogram. World J Urol. 1995;13:34–9.CrossRefGoogle Scholar
  9. 9.
    Blaivas JG, Groutz A. Bladder outlet obstruction nomogram for women with lower urinary tract symptomatology. Neurourol Urodyn. 2000;19:553–64.CrossRefGoogle Scholar
  10. 10.
    Cormier L, Ferchaud J, Galas JM, Guillemin F, Mangin P. Diagnosis of female bladder outlet obstruction and relevance of the parameter area under the curve of detrusor pressure during voiding: preliminary results. J Urol. 2002;167:2083–7.CrossRefGoogle Scholar
  11. 11.
    Powell C. Not all neurogenic bladders are the same: a proposal for a new neurogenic bladder classification system. Transl Androl Urol. 2016;5:12–21.PubMedPubMedCentralGoogle Scholar
  12. 12.
    Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. Am Fam Physician. 2008;77:643–50.PubMedGoogle Scholar
  13. 13.
    Kasturi S, Hale DS. “J” cut of sling for postoperative voiding dysfunction following synthetic midurethral slings. Int Urogynecol J. 2011;22:933–6.CrossRefGoogle Scholar
  14. 14.
    Feng WC, Churchill BM. Dysfunctional elimination syndrome in children without obvious spinal cord diseases. Pediatr Clin N Am. 2001;48:1489–504.CrossRefGoogle Scholar
  15. 15.
    Costantini E, Lazzeri M, Bini V, Zucchi A, Fioretti F, Frumenzio E, et al. Open-label, longitudinal study of tamsulosin for functional bladder outlet obstruction in women. Urol Int. 2009;83:311–5.CrossRefGoogle Scholar
  16. 16.
    Desantis DJ, Leonard MP, Preston MA, Barrowman NJ, Guerra LA. Effectiveness of biofeedback for dysfunctional elimination syndrome in pediatrics: a systematic review. J Pediatr Urol. 2011;7:342–8.CrossRefGoogle Scholar
  17. 17.
    Kajbafzadeh AM, Sharifi-Rad L, Ghahestani SM, Ahmadi H, Kajbafzadeh M, Mahboubi AH. Animated biofeedback: an ideal treatment for children with dysfunctional elimination syndrome. J Urol. 2011;186:2379–84.CrossRefGoogle Scholar
  18. 18.
    McGee SM, Routh JC, Granberg CF, Roth TJ, Hollatz P, Vandersteen DR, et al. Sacral neuromodulation in children with dysfunctional elimination syndrome: description of incisionless first stage and second stage without fluoroscopy. Urology. 2009;73:641–4; discussion 4.CrossRefGoogle Scholar
  19. 19.
    Dwyer ME, Vandersteen DR, Hollatz P, Reinberg YE. Sacral neuromodulation for the dysfunctional elimination syndrome: a 10-year single-center experience with 105 consecutive children. Urology. 2014;84:911–7.CrossRefGoogle Scholar
  20. 20.
    Stephany HA, Juliano TM, Clayton DB, Tanaka ST, Thomas JC, Adams MC, et al. Prospective evaluation of sacral nerve modulation in children with validated questionnaires. J Urol. 2013;190:1516–22.CrossRefGoogle Scholar
  21. 21.
    Groen LA, Hoebeke P, Loret N, Van Praet C, Van Laecke E, Ann R, et al. Sacral neuromodulation with an implantable pulse generator in children with lower urinary tract symptoms: 15-year experience. J Urol. 2012;188:1313–7.CrossRefGoogle Scholar
  22. 22.
    Chase J, Austin P, Hoebeke P, McKenna P. The management of dysfunctional voiding in children: a report from the Standardisation Committee of the International Children’s Continence Society. J Urol. 2010;183:1296–302.CrossRefGoogle Scholar
  23. 23.
    Yeung CK, Shei-Dei Yang S, Hoebeke P. Development and assessment of lower urinary tract function in children. In: Wein AJ, editor. Campbell-Walsh Urology. 11th ed: Elsevier; 2013. p. 3121–33.Google Scholar
  24. 24.
    Fowler CJ, Christmas TJ, Chapple CR, Parkhouse HF, Kirby RS, Jacobs HS. Abnormal electromyographic activity of the urethral sphincter, voiding dysfunction, and polycystic ovaries: a new syndrome? BMJ. 1988;297:1436–8.CrossRefGoogle Scholar
  25. 25.
    Aboseif S, Tamaddon K, Chalfin S, Freedman S, Mourad MS, Chang JH, et al. Sacral neuromodulation in functional urinary retention: an effective way to restore voiding. BJU Int. 2002;90:662–5.CrossRefGoogle Scholar
  26. 26.
    De Ridder D, Ost D, Bruyninckx F. The presence of Fowler's syndrome predicts successful long-term outcome of sacral nerve stimulation in women with urinary retention. Eur Urol. 2007;51:229–33; discussion 33–4.CrossRefGoogle Scholar
  27. 27.
    Shaker HS, Hassouna M. Sacral root neuromodulation in idiopathic nonobstructive chronic urinary retention. J Urol. 1998;159:1476–8.CrossRefGoogle Scholar
  28. 28.
    Grunewald V, Hofner K, Thon WF, Kuczyk MA, Jonas U. Sacral electrical neuromodulation as an alternative treatment option for lower urinary tract dysfunction. Restor Neurol Neurosci. 1999;14:189–93.PubMedGoogle Scholar
  29. 29.
    Jonas U, Fowler CJ, Chancellor MB, Elhilali MM, Fall M, Gajewski JB, et al. Efficacy of sacral nerve stimulation for urinary retention: results 18 months after implantation. J Urol. 2001;165:15–9.CrossRefGoogle Scholar
  30. 30.
    Everaert K, De Muynck M, Rimbaut S, Weyers S. Urinary retention after hysterectomy for benign disease: extended diagnostic evaluation and treatment with sacral nerve stimulation. BJU Int. 2003;91:497–501.CrossRefGoogle Scholar
  31. 31.
    Dasgupta R, Wiseman OJ, Kitchen N, Fowler CJ. Long-term results of sacral neuromodulation for women with urinary retention. BJU Int. 2004;94:335–7.CrossRefGoogle Scholar
  32. 32.
    van Voskuilen AC, Oerlemans DJ, Weil EH, de Bie RA, van Kerrebroeck PE. Long term results of neuromodulation by sacral nerve stimulation for lower urinary tract symptoms: a retrospective single center study. Eur Urol. 2006;49:366–72.CrossRefGoogle Scholar
  33. 33.
    Van Voskuilen AC, Oerlemans DJ, Weil EH, van den Hombergh U, van Kerrebroeck PE. Medium-term experience of sacral neuromodulation by tined lead implantation. BJU Int. 2007;99:107–10.CrossRefGoogle Scholar
  34. 34.
    van Kerrebroeck PE, van Voskuilen AC, Heesakkers JP, Lycklama á Nijholt AA, Siegel S, Jonas U, et al. Results of sacral neuromodulation therapy for urinary voiding dysfunction: outcomes of a prospective, worldwide clinical study. J Urol. 2007;178:2029–34.CrossRefGoogle Scholar
  35. 35.
    Datta SN, Chaliha C, Singh A, Gonzales G, Mishra VC, Kavia RB, et al. Sacral neurostimulation for urinary retention: 10-year experience from one UK centre. BJU Int. 2008;101:192–6.PubMedGoogle Scholar
  36. 36.
    White WM, Dobmeyer-Dittrich C, Klein FA, Wallace LS. Sacral nerve stimulation for treatment of refractory urinary retention: long-term efficacy and durability. Urology. 2008;71:71–4.CrossRefGoogle Scholar
  37. 37.
    Denzinger S, Nowrotek A, Weingart P, Burger M, Wieland WF, Rossler W, et al. Does sacral neuromodulation lead to relevant reduction in the need for intermittent catheterization? A single-center experience on patients with chronic urinary retention. Neuromodulation. 2012;15:586–91; discussion 91.CrossRefGoogle Scholar
  38. 38.
    Lombardi G, Musco S, Celso M, Del Corso F, Del Popolo G. Sacral neuromodulation for neurogenic non-obstructive urinary retention in incomplete spinal cord patients: a ten-year follow-up single-centre experience. Spinal Cord. 2014;52:241–5.CrossRefGoogle Scholar
  39. 39.
    Engeler DS, Meyer D, Abt D, Muller S, Schmid HP. Sacral neuromodulation for the treatment of neurogenic lower urinary tract dysfunction caused by multiple sclerosis: a single-centre prospective series. BMC Urol. 2015;15:105.CrossRefGoogle Scholar
  40. 40.
    Tanagho EA, Schmidt RA, Orvis BR. Neural stimulation for control of voiding dysfunction: a preliminary report in 22 patients with serious neuropathic voiding disorders. J Urol. 1989;142:340–5.CrossRefGoogle Scholar
  41. 41.
    Dasgupta R, Critchley HD, Dolan RJ, Fowler CJ. Changes in brain activity following sacral neuromodulation for urinary retention. J Urol. 2005;174:2268–72.CrossRefGoogle Scholar
  42. 42.
    DasGupta R, Fowler CJ. Urodynamic study of women in urinary retention treated with sacral neuromodulation. J Urol. 2004;171:1161–4.CrossRefGoogle Scholar
  43. 43.
    Bertapelle P, Bodo G, Carone R. Detrusor acontractility in urinary retention: detrusor contractility test as exclusion criteria for sacral neurostimulation. J Urol. 2008;180:215–6.CrossRefGoogle Scholar
  44. 44.
    Gross C, Habli M, Lindsell C, South M. Sacral neuromodulation for nonobstructive urinary retention: a meta-analysis. Female Pelvic Med Reconstr Surg. 2010;16:249–53.CrossRefGoogle Scholar
  45. 45.
    Powell CR. Neuromodulation for neurogenic bladder. In: Sandhu J, editor. Current bladder dysfunction reports: Springer; 2013. p. 282–8.CrossRefGoogle Scholar
  46. 46.
    Drake MJ, Apostolidis A, Cocci A, Emmanuel A, Gajewski JB, Harrison SC, et al. Neurogenic lower urinary tract dysfunction: clinical management recommendations of the Neurologic Incontinence committee of the fifth International Consultation on Incontinence 2013. Neurourol Urodyn. 2016;35:657–65.CrossRefGoogle Scholar
  47. 47.
    Kessler TM, La Framboise D, Trelle S, Fowler CJ, Kiss G, Pannek J, et al. Sacral neuromodulation for neurogenic lower urinary tract dysfunction: systematic review and meta-analysis. Eur Urol. 2010;58:865–74.CrossRefGoogle Scholar
  48. 48.
    Wollner J, Krebs J, Pannek J. Sacral neuromodulation in patients with neurogenic lower urinary tract dysfunction. Spinal Cord. 2016;54:137–40.CrossRefGoogle Scholar
  49. 49.
    Sievert KD, Amend B, Gakis G, Toomey P, Badke A, Kaps HP, et al. Early sacral neuromodulation prevents urinary incontinence after complete spinal cord injury. Ann Neurol. 2010;67:74–84.CrossRefGoogle Scholar
  50. 50.
    Dwyer ME, Reinberg YE. The dysfunctional elimination syndrome in children—is sacral neuromodulation worth the trouble? J Urol. 2012;188:1076–7.CrossRefGoogle Scholar
  51. 51.
    Chen G, Liao L, Dong Q, Ju Y. The inhibitory effects of pudendal nerve stimulation on bladder overactivity in spinal cord injury dogs: is early stimulation necessary? Neuromodulation. 2012;15:232–7; discussion 7.CrossRefGoogle Scholar
  52. 52.
    Krasmik D, Krebs J, van Ophoven A, Pannek J. Urodynamic results, clinical efficacy, and complication rates of sacral intradural deafferentation and sacral anterior root stimulation in patients with neurogenic lower urinary tract dysfunction resulting from complete spinal cord injury. Neurourol Urodyn. 2014;33:1202–6.CrossRefGoogle Scholar
  53. 53.
    Martens FM, Heesakkers JP. Clinical results of a brindley procedure: sacral anterior root stimulation in combination with a rhizotomy of the dorsal roots. Adv Urol. 2011;2011:709708.CrossRefGoogle Scholar
  54. 54.
    Lopez de Heredia L, Meagher TM, Jamous MA, Hughes RJ. Long-term effect of MRI on sacral anterior root stimulator: the Stoke Mandeville experience. Spinal Cord. 2012;50:294–7.CrossRefGoogle Scholar
  55. 55.
    Sanford MT, Suskind AM. Neuromodulation in neurogenic bladder. Transl Androl Urol. 2016;5:117–26.CrossRefGoogle Scholar
  56. 56.
    Monteiro ES, de Carvalho LB, Fukujima MM, Lora MI, do Prado GF. Electrical stimulation of the posterior tibialis nerve improves symptoms of poststroke neurogenic overactive bladder in men: a randomized controlled trial. Urology. 2014;84:509–14.CrossRefGoogle Scholar
  57. 57.
    Panicker JN, Fowler CJ. Lower urinary tract dysfunction in patients with multiple sclerosis. Handb Clin Neurol. 2015;130:371–81.CrossRefGoogle Scholar
  58. 58.
    Brucker BM, Nitti VW, Kalra S, Herbert J, Sadiq A, Utomo P, et al. Barriers experienced by patients with multiple sclerosis in seeking care for lower urinary tract symptoms. Neurourol Urodyn. 2017;36(4):1208–13.CrossRefGoogle Scholar
  59. 59.
    Tracey JM, Stoffel JT. Secondary and tertiary treatments for multiple sclerosis patients with urinary symptoms. Invest Clin Urol. 2016;57:377–83.CrossRefGoogle Scholar
  60. 60.
    Medtronic. MRI Guidelines for InterStim Therapy neurostimulation systems. http://manualsmedtroniccom/wcm/groups/mdtcom_sg/@emanuals/@era/@neuro/documents/documents/contrib_214172pdf: Medtronic Inc.; 2016.Google Scholar
  61. 61.
    Gobbi C, Digesu G, Khullar V, El Neil S, Caccia G, Zecca C. Percutaneous posterior tibial nerve stimulation as an effective treatment of refractory lower urinary tract symptoms in patients with multiple sclerosis: preliminary data from a multicentre, prospective, open label trial. Mult Scler. 2011;17(12):1514–9.CrossRefGoogle Scholar
  62. 62.
    Kabay S, Kabay SC, Yucel M, Ozden H, Yilmaz Z, Aras O, et al. The clinical and urodynamic results of a 3-month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis-related neurogenic bladder dysfunction. Neurourol Urodyn. 2009;28:964–8.CrossRefGoogle Scholar
  63. 63.
    de Seze M, Raibaut P, Gallien P, Even-Schneider A, Denys P, Bonniaud V, et al. Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study. Neurourol Urodyn. 2011;30:306–11.CrossRefGoogle Scholar
  64. 64.
    Chen G, Liao L. Sacral neuromodulation for neurogenic bladder and bowel dysfunction with multiple symptoms secondary to spinal cord disease. Spinal Cord. 2014.Google Scholar
  65. 65.
    Kajbafzadeh AM, Sharifi-Rad L, Baradaran N, Nejat F. Effect of pelvic floor interferential electrostimulation on urodynamic parameters and incontinency of children with myelomeningocele and detrusor overactivity. Urology. 2009;74:324–9.CrossRefGoogle Scholar
  66. 66.
    Xiao CG, MX D, Dai C, Li B, Nitti VW, de Groat WC. An artificial somatic-central nervous system-autonomic reflex pathway for controllable micturition after spinal cord injury: preliminary results in 15 patients. J Urol. 2003;170:1237–41.CrossRefGoogle Scholar
  67. 67.
    Xiao CG, MX D, Li B, Liu Z, Chen M, Chen ZH, et al. An artificial somatic-autonomic reflex pathway procedure for bladder control in children with spina bifida. J Urol. 2005;173:2112–6.CrossRefGoogle Scholar
  68. 68.
    Peters KM, Girdler B, Turzewski C, Trock G, Feber K, Nantau W, et al. Outcomes of lumbar to sacral nerve rerouting for spina bifida. J Urol. 2010;184:702–7.CrossRefGoogle Scholar
  69. 69.
    Rasmussen MM, Rawashdeh YF, Clemmensen D, Tankisi H, Fuglsang-Frederiksen A, Krogh K, et al. The artificial somatoautonomic reflex arch does not improve lower urinary tract function in patients with spinal cord lesions. J Urol. 2015;193:598–604.CrossRefGoogle Scholar
  70. 70.
    Xiao C-G. Bladder re-innervation—state of the art. Current Bladder Dysfunction Reports—Neurogenic Bladder, Zeitschrift. 2016:386–90.CrossRefGoogle Scholar
  71. 71.
    Rademakers KL, Drossaerts JM, van Kerrebroeck PE, Oelke M, van Koeveringe GA. Prediction of sacral neuromodulation treatment success in men with impaired bladder emptying-time for a new diagnostic approach. Neurourol Urodyn. 2017;36(3):808–10.CrossRefGoogle Scholar
  72. 72.
    Bansal R, Agarwal MM, Modi M, Mandal AK, Singh SK. Urodynamic profile of diabetic patients with lower urinary tract symptoms: association of diabetic cystopathy with autonomic and peripheral neuropathy. Urology. 2011;77:699–705.CrossRefGoogle Scholar
  73. 73.
    Oelke M, Rademakers KL, van Koeveringe GA, et al. Unravelling detrusor underactivity: Development of a bladder outlet resistance- bladder contractility nomogram for adult male patients with lower urinary tract symptoms. Neurourol Urodyn. 2015; Epub ahead of print.Google Scholar
  74. 74.
    Juszczak K, Drewa T. Pharmacotherapy in detrusor underactivity: a new challenge for urologists and pharmacologists (from lab to clinic). Pharmacol Rep. 2016;68:703–6.CrossRefGoogle Scholar
  75. 75.
    Cohn JA, Kowalik CG, Kaufman MR, Reynolds WS, Milam DF, Dmochowski RR. Evaluation of the axonics modulation technologies sacral neuromodulation system for the treatment of urinary and fecal dysfunction. Expert Rev Med Devices. 2017;14(1):3–14.CrossRefGoogle Scholar
  76. 76.
    Heins S. Axionics sacral neuromodulation system receives CE mark for the treatment of urinary and fecal dysfunction. 2016.Google Scholar
  77. 77.
    Powell CR. Conditional electrical stimulation in animal and human models for neurogenic bladder: working toward a neuroprosthesis. Curr Bladder Dysfunct Rep. 2016;11:379–85.CrossRefGoogle Scholar
  78. 78.
    Wenzel BJ, Boggs JW, Gustafson KJ, Grill WM. Closed loop electrical control of urinary continence. J Urol. 2006;175:1559–63.CrossRefGoogle Scholar
  79. 79.
    Mathews KS, Wark HA, Warren DJ, Christensen MB, Nolta NF, Cartwright PC, et al. Acute monitoring of genitourinary function using intrafascicular electrodes: selective pudendal nerve activity corresponding to bladder filling, bladder fullness, and genital stimulation. Urology. 2014;84:722–9.CrossRefGoogle Scholar
  80. 80.
    Mendez A, Sawan M, Minagawa T, Wyndaele JJ. Estimation of bladder volume from afferent neural activity. IEEE Trans Neural Syst Rehabil Eng. 2013;21:704–15.CrossRefGoogle Scholar
  81. 81.
    Kim A, Powell CR, Ziaie B. An Universal packaging technique for low-drift implantable pressure sensors. Biomed Microdevices. 2016;18:32.CrossRefGoogle Scholar

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© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of UrologyIndiana University School of MedicineIndianapolisUSA

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