Physiotherapy Approaches on Neurogenic Bladder

Document Type : Review Article

Authors

1 1. Student Research Committee. MSc Student of Physiotherapy, International Branch, Shahid Beheshti University of Medical Sciences,Tehran, Iran.

2 2. Asisstant Professor of Physiotherapy, Faculty of Rehabilitation Sciences, Shahid Beheshti University of Medical Sciences. Tehran, Iran.

Abstract

Background and Aim: Neurogenic bladder is lower urinary tract dysfunction due to the neurological disease or damage to the nervous system. This condition is associated with impaired nerve conduction in the central, peripheral and autonomic nervous systems, which can affect the bladder and urethral function. Urodynamic studies are essential for diagnosis and choosing suitable treatment approach. Common treatment methods are included medication, physiotherapy and surgery. The present article aimed to review different types of neurogenic bladders and physiotherapy approaches to manage them.
Conclusion: Due to the drug’ side effects and being invasive and high costs of the surgery, physiotherapy can be a first option in the treatment of neurogenic bladder. Percutaneous posterior tibial nerve stimulation is a simple, useful and effective method without any complications. In addition, biofeedback and pelvic floor muscle training considering as the first- line treatment.

Keywords


Ginsberg, D., The epidemiology and Pathophysiology of Neurogenic Bladder. Am J Manag Care, 2013; 19(10 suppl  ): s191-6.
2.   Fowler, C. and K. O’Malley, Investigation and management of neurogenic bladder dysfunction. Journal of Neurology, Neurosurgery & Psychiatry, 2003; 74(suppl 4): iv27-iv31.
3.   Ersoz, M., et al., Noninvasive evaluation of lower urinary tract function in children with cerebral palsy. American Journal of Physical Medicine & Rehabilitation, 2009; 88(9): 735-741.
4.   Jonas, U., et al., Neurogenic voiding dysfunctions (NVD). European urology, 2003; 44(3): I-XV.
5.   Ozturk, M., et al., Bladder and bowel control in children with cerebral palsy: case-control study. Croatian medical journal, 2006; 47(2): 264-270.
6.   Silva, J.A.F., et al., Lower urinary tract dysfunction in children with cerebral palsy. Neurourology and urodynamics, 2009; 28(8): 959-963.
7.   Soleimani, F., et al., Survey on types and associated disorders of cerebral palsy in eastern and northern districts of Tehran. Journal of Rehabilitation, 2011; 12(3): 75-82.
8.   Staskin, D.R., et al., Percutaneous tibial nerve stimulation: a clinically and cost effective addition to the overactive bladder algorithm of care. Current urology reports, 2012; 13(5): 327-334.
9.   Reid, C. and M. Borzyskowski, Lower urinary tract dysfunction in cerebral palsy. Archives of disease in childhood, 1993; 68(6): 739-742.
10. Al Mousa, R.T. and M.M. Hassouna, Electrical stimulation in the treatment of neurogenic bladder dysfunction. CurrentBladder Dysfunction Reports, 2008; 3(4): 195-202.
11. Burks, F.N., D.T. Bui, and K.M. Peters, Neuromodulation and the neurogenic bladder. Urologic Clinics of North America, 2010; 37(4):559-565.
12. de Sèze, M., et al., Transcutaneous posterior tibial nerve stimulation for treatment of the overactive bladder syndrome in multiple sclerosis: results of a multicenter prospective study. Neurourology and urodynamics, 2011; 30(3): 306-311.
13. Bergman, J., J.R. Robertson, and G. Elia, Effects of a magnetic fieldon pelvic floor muscle function in women with stress urinary incontinence. Alternat Ther Health Med, 2004; 10(  3): 70-2.
14. Peco-AntiÄ, A., et al., Bladder control training in girls with lower urinary tract dysfunction. International braz j urol, 2013; 39(1) : 118-127.
15. Kegel, A.H., Physiologic therapy for urinary stress incontinence. Journal of the American Medical Association, 1951; 146(10): 915-917.
16. Miller, J.M., et al., Clarification and confirmation of the Knack maneuver: the effect of volitional pelvic floor muscle contraction to preempt expected stress incontinence. International Urogynecology Journal, 2008; 19(6): 773-782.
17.Riyad T. Al Mousa, Magdy M. Hassouna . Electrical Stimulation in the Treatment of Neurogenic Bladder Dysfunction.Current Bladder Dysfunction Reports . 2008; 3( 4): 195-202.
18. Stoller, M., Afferent nerve stimulation for pelvic floor dysfunction.Eur Urol, 1999; 35 (suppl 2): 16.
19. Tai, C., et al., Irritation induced bladder overactivity is suppressed by tibial nerve stimulation in cats. The Journal of urology, 2011; 186(1): 326-330.
20. Finazzi, A.E., et al., Posterior tibial nerve stimulation: is the once-a-week protocol the best option? Minerva urologica e nefrologica, The Italian journal of urology and nephrology, 2005; 57(2): 119-123.
21. Jiang, C.H. and S. Lindström, Prolonged enhancement of the micturition reflex in the cat by repetitive stimulation of bladder afferents. The Journal of physiology, 1999; 517(2): 599-605.
22. Tai, C., et al., Prolonged poststimulation inhibition of bladder activity induced by tibial nerve stimulation in cats. American Journal of Physiology-Renal Physiology, 2011; 300(2): F385.
23. Danisman, A., et al., Tibial nerve stimulation diminishes mast cell infiltration in the bladder wall induced by interstitial cystitis urine. Scandinavian journal of urology and nephrology, 2007; 41(2): 98-102.
24. Chang, C.J., et al., Electroacupuncture decreases c-fos expression in the spinal cord induced by noxious stimulation of the rat bladder. The Journal of urology, 1998; 160(6): 2274-2279.
25. Finazzi‐Agrò, E., et al., Percutaneous tibial nerve stimulation produces effects on brainactivity: study on the modifications of the long latency somatosensory evoked potentials. Neurourology and urodynamics, 2009; 28(4): 320-324.
26. Vandoninck, V., et al., Percutaneous tibial nerve stimulation in the treatment of overactive bladder: urodynamic data. Neurourology and urodynamics, 2003; 22(3): 227-232.
27. Klingler, H., et al., Use of peripheral neuromodulation of the S3 region for treatment of detrusor overactivity: a urodynamic-based study. Urology, 2000; 56(5): 766-771.
28. Peters, K.M., et al., Randomized trial of percutaneous tibial nerve stimulation versus extended-release tolterodine: results from the overactive bladder innovative therapy trial. The Journal of urology, 2009; 182(3): 1055-1061.
29. Van Der Pal, F., et al., Correlation between quality of life and voiding variables in patients treated with percutaneous tibial nerve stimulation. BJU international, 2006; 97(1): 113-116.
30. Kabay, S.C., et al., Acute urodynamic effects of percutaneous posterior tibial nerve stimulation on neurogenic detrusor overactivity in patients with Parkinson's disease. Neurourology and urodynamics, 2009;28(1): 62-67.
31. Kabay, S., 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. Neurourology and urodynamics, 2009; 28(8): 964-968.
32. Gobbi, C., et al., Percutaneous posterior tibial nerve stimulation as an effective treatment of refractorylower urinary tract symptoms in patients with multiple sclerosis: preliminary data from a multicentre, prospective, open label trial. Multiple Sclerosis Journal, 2011; 17(12): 1514-1519.
33. Hoebeke, P., et al., Percutaneous electrical nerve stimulation in children with therapy resistant nonneuropathic bladder sphincter dysfunction: a pilot study. The Journal of urology, 2002; 168(6): 2605-2608.
34. De Gennaro, M., et al., Percutaneous tibial nerve neuromodulation is well tolerated in children and effective for treating refractory vesical dysfunction. The Journal of urology, 2004; 171(5): 1911-1913.
35.Capitanucci, M.L., et al., Long-term efficacy of percutaneous tibial nerve stimulation for different types of lower urinary tract dysfunction inchildren. The Journal of urology, 2009; 182(4): 2056-2061.
36. Van Der Pal, F., et al., Percutaneous tibial nerve stimulation in the treatment of refractory overactive bladder syndrome: is maintenance treatment necessary? BJU international, 2006; 97(3):547-550.
37. Vandoninck, V., et al., Posterior tibial nerve stimulation in the treatment of voiding dysfunction: urodynamic data. Neurourology and urodynamics, 2004; 23(3): 246-251.
38. Van Balken, M., H. Vergunst, and B. Bemelmans, Prognostic factors for successful percutaneous tibial nerve stimulation. European urology, 2006; 49(2): 360-365.
39. Chapple, C.R., S.A. MacDiarmid, and A. Patel, Urodynamics made easy,2009; Churchill Livingstone.
40. Voorham-van der Zalm PJ, Pelger RC, Stiggelbout AM, Elzevier HW, Lycklama à Nijeholt GA. Effects of magnetic stimulation in the treatment of pelvic floor dysfunction. BJU Int. 2006;97(5):1035-8.
41. Bourcier A, M.E., Abrams P., Pelvic Floor Disorders. Elsevier Saunders, 2004; p. 131-235.
42. Pannek, J., et al., Guidelines on neurogenic lower urinary tract dysfunction. European Association of Urology, 2013.
43. Bo, K., et al., Evidence-based physical therapy for the pelvic floor: bridging science and clinical practice,2007; Elsevier Health Sciences.
44. Hay-Smith EJ, Bø Berghmans LC, Hendriks HJ, de Bie RA, van Waalwijk van Doorn ES. Pelvic floor muscle training for urinary incontinence in women. The Cochrane Database Syst Rev.2001 ;( 1):CD001407.
 
Volume 4, Issue 1 - Serial Number 1
March and April 2015
Pages 124-132
  • Receive Date: 11 May 2014
  • Revise Date: 08 September 2014
  • Accept Date: 12 October 2014
  • First Publish Date: 21 March 2015