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. 2023 Aug;42(6):1318-1328.
doi: 10.1002/nau.25205. Epub 2023 May 20.

Noninvasive brain stimulation in the treatment of functional urological and pelvic floor disorders: A scoping review

Charles Mazeaud  1   2 , Betsy H Salazar  1 , Rose Khavari  1
Affiliations

Noninvasive brain stimulation in the treatment of functional urological and pelvic floor disorders: A scoping review

Charles Mazeaud et al. Neurourol Urodyn. 2023 Aug.

Abstract

Introduction: Functional pelvic floor disorders (PFD) such as bowel and bladder dysfunctions can be challenging to manage with our current therapeutic modalities. Recently, noninvasive brain stimulation has emerged as a novel strategy for noninvasive pelvic floor management. Here, we assessed the current state of research on this topic.

Methods: A scoping review was conducted with Pubmed, Web of Science, and Embase, in conjunction with clinicaltrials.gov, encompassing all manuscripts published without past time limit up until June 30, 2022.

Results: Of the 880 abstracts identified in a blind selection by two reviewers, 14 publications with an evidence level of 1 or 2 (Oxford scale) were eligible and included in this review. Review articles, case reports (<5 patients), letters, and protocol studies were excluded. PFDs were described as either pelvic pain or lower urinary tracts symptoms (LUTS) with repeated transcranial magnetic stimulation (rTMS) as the most common treatment modality. Despite heterogeneous therapeutic protocols, significant improvements were observed such as reduction in postvoid residual of urine, increased bladder capacity, improved voiding flow paraments, and decreased chronic pelvic, and bladder pain. No appreciable adverse effects were noted. However, low sample populations allowed only provisional conclusions.

Conclusion: Noninvasive transcranial neurostimulation for LUTS and pelvic pain is emerging as an effective tool for clinicians to utilize in the future. Further investigation is needed to elucidate the full significance of the indicated outcomes.

Keywords: pelvic floor disorder; pelvic pain; transcranial direct current stimulation; transcranial magnetic stimulation; urination disorder.

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Conflict of interest statement

Conflicts of Interest: The authors declare no competing interests.

Figures

Figure 1.
Figure 1.
Noninvasive neuronavigated stimulation. A) Repetitive transcranial magnetic stimulation (rTMS) is a form of noninvasive stimulation that allows for targeted inhibition and excitation of cortical networks (created with BioRender.com). B) Magstim BiStim2 TMS system used along with Brainsight neuronavigation for accurate targeted neuromodulation.
Figure 2.
Figure 2.
Flowchart for the selection and inclusion process
See this image and copyright information in PMC

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