Functional electrical stimulation (FES) in micturition disorders

Abstract

Electrical stimulation has been employed for over 50 years as a complementary therapeutic tool in rehabilitative conservative treatment of stress and mixed urinary incontinence either in female or male adult subjects but also as symptomatic treatment of overactive bladder and chronic pelvic pain. Moreover, a kind of this methodology such as the intravesical electrical stimulation has been proposed to restore micturitional balance in chronic urinary retention following incomplete lesion of sacral neural pathways. Unfortunately literature concerning results of this methodology remains debated and controversial because of a wide spectrum of materials, methods, and indications proposed and a critical lack of well-substantiated biologic rationale underpinning their use in clinical practice. Nevertheless, the applicability, effectiveness, and safety of functional electrical stimulation have been proved in a large cohort of clinical studies, and it continues to be used as a valid tool in urologic rehabilitative treatment of many voiding disorders. In this chapter we describe materials, methods, indications, and results of the more employed clinical applications of functional electrical stimulation in the treatment of storage and emptying disorders of micturition through personal experience and literature reviews.