Efficacy and safety of transcutaneous electrical nerve stimulation combined with clean intermittent catheterization for neurogenic bladder dysfunction in patients with cauda equina syndrome

Abstract

Purpose: Cauda equina syndrome (CES) due to lumbar disk herniation often leads to bladder dysfunction, severely affecting patients' quality of life. This study aims to evaluate the effectiveness of percutaneous electrical stimulation (TENS) combined with clean intermittent catheterization (CIC) for improving bladder function in CES patients.

Methods: A total of 40 patients with bladder dysfunction caused by CES who underwent posterior lumbar spinal fusion from January 2020 to December 2022 were included. Based on the method of catheterization, patients were divided into the CIC or indwelling catheterization (IC) group. Both groups received TENS treatment twice a week for 8 weeks. Urodynamic parameters and quality of life (I-QOL) were assessed before and after treatment.

Results: Significant improvements were observed in the CIC group, with reductions in daily urination frequency (DUF, p < 0.05), increases in daily average single urine volume (DASUV, p < 0.05), and improved urodynamic parameters (MBC, p = 0.031; DP, p < 0.001) compared to the IC group. The CIC group also showed a lower incidence of urinary tract infections. Quality of life significantly improved in both groups, with the CIC group showing a greater improvement (p = 0.036).

Conclusions: TENS combined with CIC significantly improves bladder function and quality of life in CES patients, with a lower risk of urinary tract infections compared to indwelling catheterization.

Keywords: Cauda equina syndrome; Clean intermittent catheterization; Neurogenic bladder dysfunction; Transcutaneous electrical nerve stimulation.