Spinal cord injuries (SCIs) can cause lower urinary tract (LUT) dysfunction, specifically neurogenic bladder, which affects 70%–84% of SCI patients. The current treatment options are limited and may trigger medical complications, leading to a significant decrease in quality of life. Therefore, restoring LUT function is a high priority for individuals living with SCI disabilities. The use of electrical spinal cord stimulation (ESCS) has been shown to be effective in restoring lost functions in some individuals with neurological impairments of this system.
The objective of this thesis research project was to explore the investigation of different electrical stimulation modalities as a clinical or experimental treatment for bladder dysfunction, resulting from SCI-related LUT dysfunction. This paper aimed to provide a comprehensive outline of the intricate anatomy, neuroanatomy, and physiology of the LUT, highlighting how disruptions to these systems might result in LUT dysfunctions after clinical SCI. The strengths and limitations of each ESCS modality were systematically analyzed, with particular attention given to efficacy evaluation and the issues of side effects and safety.
Overall, the findings suggest that ESCS, which is an established clinical therapy for managing chronic neuropathic pain, has demonstrated the potential to be repurposed to provide a safe, sustainable, and impactful treatment for bladder abnormalities in individuals with SCI. However, because of the limited knowledge about the LUT-specific mechanisms of ESCS action, more research investments are required before stimulation parameters including the appropriate timing and electrode location can be further improved to maximize ESCS-mediated improvement of LUT function after SCI.
Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48395 |
Date | 14 March 2024 |
Creators | Usuga, Esteban |
Contributors | Spencer, Jean L., Teng, Yang D. |
Source Sets | Boston University |
Language | en_US |
Detected Language | English |
Type | Thesis/Dissertation |
Rights | Attribution 4.0 International, http://creativecommons.org/licenses/by/4.0/ |
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