Efficacy in Using Urodynamic Parameters of Intravesical Electrical Stimulation for Detrusor Underactivity

Objective: Intravesical electrical stimulation (IVES) remains a controversial therapy for detrusor underactivity (DUA). The purpose of this study is to determine the efficacy of IVES in patients with DUA using pre- and post -IVES urodynamic parameters. Methods: Intravesical electrical stimulation procedure is performed using a specific catheter equipped with an internal electrical electrode (cathode). The anode is subsequently affixed to the lower abdomen (suprapubic). Afterward, this specialized catheter is connected to a stimulator. Patients undergo a series of 12 IVES procedures in 1 month with the following predetermined parameters: 20 mA amplitude, 20 Hz frequency, 200 mu s pulse width, and 60 minutes stimulation time. Patients underwent a follow-up urodynamic examination 1 month after the IVES series is completed. Results: After IVES, several notable changes were observed, including an increase in Qmax from 7.28 +/- 5.24 to 7.29 +/- 4.09 ( P = .030), a decrease in post -void residual (PVR) from 73.03 +/- 43.91 to 62.07 +/- 39.10 ( P = .005), and an increase in PDet@tQmax from 17.10 +/- 12.35 to 18.87 +/- 12.47 ( P = .009). The aetiologies of DUA were categorized into 3 groups: chronic obstruction (CO), idiopathic (Idio), and neurological disorder (ND). The CO group exhibited significant changes in urodynamic parameters, specifically Qmax ( P = .001), PVR ( P = .001), and PDet@Qmax ( P = .035). Similarly, the idiopathic group also demonstrated improvements in Qmax ( P = .008), PVR ( P = .037), and PDet@ Qmax ( P = .033). Conclusion: Intravesical electrical stimulation has been shown to have a positive effect on patients diagnosed with DUA, particularly those whose DUA is idiopathic or due to chronic obstruction.