Abstract：
OBJECTIVE: This review aims to assess the efficacy of transcutaneous electrical nerve stimulation (TENS) for neurogenic bladder after spinal cord injury (SCI).
METHODS: A systematic search was conducted of seven electronic data bases from inception to Dec 31, 2022, to identify randomized controlled trials that studied TENS for neurogenic bladder after SCI. The primary outcomes were maximum cystometric capacity (MCC) and residual urine volume (RUV). Secondary outcomes included maximum detrusor pressure, flow rate, and bladder diary. Random effects models were used in all analyses.
RESULTS: Eleven trials involving 881 participants were included. Meta-analysis showed that TENS in addition to conventional treatment had larger MCC (mean difference [MD] 50.55 ml, 95% CI 27.81-73.29, p＜0.0001) and lower RUV (MD -22.96 ml, 95% CI -33.45 to -12.47, p＜0.0001) than did conventional treatment only. Compared with magnetic stimulation, no differences were observed with TENS for MCC (MD -14.49 ml, 95% CI -48.97 to 19.98, p = 0.41) and RUV (MD 25 ml, 95% CI -61.79 to 111.79, p = 0.57). There also were no differences in MCC (MD -7.2 ml, 95% CI -14.56 to 0.16, p= 0.06) and (MD -5.2 ml, 95% CI -60.00 to 49.60, p = 0.851) when compared with solifenacin succinate and pelvic floor biofeedback, respectively.
CONCLUSIONS: TENS may be an effective treatment option for neurogenic bladder after SCI.
METHODS: A systematic search was conducted of seven electronic data bases from inception to Dec 31, 2022, to identify randomized controlled trials that studied TENS for neurogenic bladder after SCI. The primary outcomes were maximum cystometric capacity (MCC) and residual urine volume (RUV). Secondary outcomes included maximum detrusor pressure, flow rate, and bladder diary. Random effects models were used in all analyses.
RESULTS: Eleven trials involving 881 participants were included. Meta-analysis showed that TENS in addition to conventional treatment had larger MCC (mean difference [MD] 50.55 ml, 95% CI 27.81-73.29, p＜0.0001) and lower RUV (MD -22.96 ml, 95% CI -33.45 to -12.47, p＜0.0001) than did conventional treatment only. Compared with magnetic stimulation, no differences were observed with TENS for MCC (MD -14.49 ml, 95% CI -48.97 to 19.98, p = 0.41) and RUV (MD 25 ml, 95% CI -61.79 to 111.79, p = 0.57). There also were no differences in MCC (MD -7.2 ml, 95% CI -14.56 to 0.16, p= 0.06) and (MD -5.2 ml, 95% CI -60.00 to 49.60, p = 0.851) when compared with solifenacin succinate and pelvic floor biofeedback, respectively.
CONCLUSIONS: TENS may be an effective treatment option for neurogenic bladder after SCI.
摘要：
目的：本综述旨在评估经皮神经电刺激（TENS）对脊髓损伤（SCI）后神经源性膀胱的疗效。
方法：从开始到2022年12月31日，对七个电子数据库进行了系统搜索，以确定研究TENS用于SCI后神经源性膀胱的随机对照试验。主要结果是最大膀胱容量（MCC）和残余尿量（RUV）。次要结果包括最大逼尿肌压力，流量,和膀胱日记。在所有分析中使用随机效应模型。
结果：11项试验纳入881名参与者。Meta分析显示，TENS除常规治疗外，MCC更大（平均差异[MD]50.55ml，95%CI27.81-73.29，p＜0.0001）和较低的RUV（MD-22.96ml，95%CI-33.45至-12.47，p＜0.0001）比仅常规治疗。与磁刺激相比,TENS对MCC没有观察到差异（MD-14.49ml，95%CI-48.97至19.98，p=0.41）和RUV（MD25ml，95%CI-61.79至111.79，p=0.57）。MCC也没有差异(MD-7.2ml，95%CI-14.56至0.16，p=0.06）和（MD-5.2ml，与琥珀酸索利那新和盆底生物反馈相比，95%CI-60.00至49.60，p=0.851)，分别。
结论：TENS可能是SCI后神经源性膀胱的有效治疗选择。
方法：从开始到2022年12月31日，对七个电子数据库进行了系统搜索，以确定研究TENS用于SCI后神经源性膀胱的随机对照试验。主要结果是最大膀胱容量（MCC）和残余尿量（RUV）。次要结果包括最大逼尿肌压力，流量,和膀胱日记。在所有分析中使用随机效应模型。
结果：11项试验纳入881名参与者。Meta分析显示，TENS除常规治疗外，MCC更大（平均差异[MD]50.55ml，95%CI27.81-73.29，p＜0.0001）和较低的RUV（MD-22.96ml，95%CI-33.45至-12.47，p＜0.0001）比仅常规治疗。与磁刺激相比,TENS对MCC没有观察到差异（MD-14.49ml，95%CI-48.97至19.98，p=0.41）和RUV（MD25ml，95%CI-61.79至111.79，p=0.57）。MCC也没有差异(MD-7.2ml，95%CI-14.56至0.16，p=0.06）和（MD-5.2ml，与琥珀酸索利那新和盆底生物反馈相比，95%CI-60.00至49.60，p=0.851)，分别。
结论：TENS可能是SCI后神经源性膀胱的有效治疗选择。
