Effect of Repetitive Transcranial Magnetic Stimulation on Detrusor Non-Reflective Neurogenic Bladder after Spinal Cord Injury
Objective To investigate the effect of repetitive transcranial magnetic stimulation (rTMS) in the treatment of detrusor non-reflective neurogenic bladder after spinal cord injury. Methods Sixty patients with neurogenic bladder after spinal cord injury admitted to Rizhao People's Hospital of Shandong Province from January 2018 to June 2023 were selected as the research objects,and were divided into a control group (n=30) and an observation group (n=30) according to random number method. The control group was treated with traditional intermittent catheterization,on the basis of which,the observation group was treated with rTMS. The urodynamics,Barthel index (BI) score,spinal cord injury or dysfunction quality of life rating scale (SCIDQLRS) score and complication rate were compared between the two groups before treatment and 4,14 and 24 weeks after treatment. Results At 4,14 and 24 weeks after treatment,the residual urine volume in both groups was lower than before treatment,and the internal bladder pressure was higher than before treatment,and the residual urine volume in the observation group was lower than that in the control group,and the internal bladder pressure was higher than that in the control group,with statistical significance (P<0.05);BI and SCIDQLRS score were higher than before treatment,and observation group were higher than those in control group,the difference was statistically significant (P<0.05). At 4,14 and 24 weeks after treatment,the maximum bladder volumes of both groups decreased compared with that before treatment,the differences were statistically significant (P<0.05);however,there were no significant differences between the two groups at the same time (P>0.05). The incidence of urinary tract infection in the observation group was 46.67％,lower than 70.00％ in the control group,and the difference was statistically significant (P<0.05);there were no significant differences in the incidences of kidney stones (or hydronephrosis) and renal insufficiency between the two groups (P>0.05). Conclusion rTMS combined with intermittent catheterization can effectively improve urodynamics,ability of daily living and quality of life in patients with detrusor non-reflective neurogenic bladder after spinal cord injury,reduce the incidence of urinary tract infection,and the clinical effect is sustainable.
Spinal cord injuryDetrusor non-reflective neurogenic bladderRepetitive transcranial magnetic stimulationIntermittent catheterizationUrodynamicsAbility of daily living
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