International Journal of Emergency and Trauma Nursing and Practices Original Research
A Single Case Report of Sacral Nerve Stimulation in Neurogenic Bladder Dysfunction: A Physiotherapeutic Perspective
Abstract
Background: This case study evaluates the effectiveness of sacral nerve stimulation (SNS) for improving neurological bladder function in a 34-year-old male patient, who underwent surgical intervention at the level of L4 for Conus Medullaris Syndrome. The patient presented with severe neurological deficits including bladder dysfunction.
Method: Post-surgery, a targeted physiotherapy regimen, including faradic current stimulation to the sacral nerves (S2-S4) and conventional exercises was implemented to address bladder function. Pre- and post-intervention evaluations were carried out using Manual Muscle Testing (MMT) and the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF).
Result: Notable improvements were seen: MMT scores rose from 0 to 3, and ICIQ-UI SF scores decreased from 20 to 9, indicating the potential effectiveness of SNS in treating neurogenic bladder dysfunction. The p-value was 0.046, which is below 0.05, confirming that the differences in MMT and ICIQ-UI SF scores are statistically significant.
Conclusion: SNS demonstrated effectiveness in improving bladder function and quality of life for the patient. These results emphasize the value of incorporating SNS into clinical practice for individuals with neurogenic bladder dysfunction.
Keywords
References (17)
- Abedi A, Heesakkers J, Zong H, Wang W, D’Ancona C, Yamaguchi O, et al. Health care economic burden of treatment and rehabilitation for neurogenic lower urinary tract dysfunction: a systematic review. J Urol. 2022; 208(4): 773–
- Suskind AM. Neurogenic bladder. In: McAninch JW, Lue TF, editors. Smith & Tanagho's General Urology. 19th Edn. New York: McGraw Hill; 2020.
- Hamid R, Averbeck MA, Chiang H, Garcia A, Al Mousa RT, Oh SJ, et al. Epidemiology and pathophysiology of neurogenic bladder after spinal cord injury. World J Urol. 2018; 36(10): 1517–
- Fitzgerald MP, Stablein U, Brubaker L. Urinary habits among asymptomatic women. Am J Obstet Gynecol. 2002; 187(5):1384–
- Latini JM, Mueller E, Lux MM, Fitzgerald MP, Kreder KJ. Voiding frequency in a sample of asymptomatic American men. J Urol. 2004; 172(3): 980–
- Bacsu CD, Chan L, Tse V. Diagnosing detrusor sphincter dyssynergia in the neurological patient. BJU Int. 2012; 109(Suppl 3):31–
- Dorsher PT, McIntosh PM. Neurogenic Bladder. Advances in Urology. 2012;2012:1-16. doi:10.1155/2012/816274
- Goldman HB, Lloyd JC, Noblett KL, Carey MP, Castaño Botero JC, Gajewski JB, et al. International Continence Society best practice statement for use of sacral neuromodulation. Neurourology and Urodynamics. 2018;37(5):1823-1848. doi:10.1002/nau.23515
- Cuthbert SC, Goodheart GJ Jr. On the reliability and validity of manual muscle testing: a literature review. Chiropr Osteopat. 2007; 15:
- Hajebrahimi S, Nourizadeh D, Hamedani R, Pezeshki MZ. Validity and reliability of the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form and its correlation with urodynamic findings. Urol J. 2012; 9(4):685–90.
- Wang X, Chen JDZ. Therapeutic potential and mechanisms of sacral nerve stimulation for gastrointestinal diseases. J Gastroenterol. 2023; 58(1): 1–
- Miller JA, et al. Sacral nerve stimulation for fecal incontinence: a systematic review and meta-analysis. Dis Colon Rectum. 2016; 59(3): 227–
- Coolen RL, Groen J, Blok B. Electrical stimulation in the treatment of bladder dysfunction: technology update. Med Devices (Auckl). 2019; 12: 337–45.
- Bordeianou LG, Thorsen AJ, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the Management of Fecal Incontinence. Dis Colon Rectum. 2023; 66(5): 647–
- Alzayer T. The effect of using a combined electrical stimulation therapy on improving sensory and motor functions of the bladder and the bowel in children with myelomeningocele: a case series. SAGE Open Med Case Rep. 2024; 12: 1–6.
- Ratan SK, Rattan KN, Jhajhria P, Mathur YP, Jhanwar A, Kondal D. The surged faradic stimulation to the pelvic floor muscles as an adjunct to the medical management in children with rectal prolapse. BMC Pediatr. 2009; 9:
- Redij S, Ambolkar A, Kenkre G. Effectiveness of pelvic floor exercises along with faradic stimulation on bladder retention and quality of life in post-operative case of cauda equina syndrome. Acta Sci Orthop. 2022; 5(3): 42–