Comprehensive Bladder Management Program Combined with a Biofeedback Stimulator in Neurogenic Bladder Rehabilitation

Summary

Here, we present a protocol to evaluate the feasibility and effectiveness of a comprehensive bladder management program combined with biofeedback stimulator therapy for neurogenic bladder rehabilitation. This protocol includes step-by-step implementation, outcome assessments, and highlights its application in improving bladder capacity, reducing residual urine volume, and alleviating urinary incontinence symptoms.

Abstract

Neurogenic Bladder (NB) refers to the dysfunction of the urinary tract caused by damage to the central nervous system or peripheral nerves that control urination. The combination of Comprehensive Bladder Management (CBM) and biofeedback stimulator is one of the rehabilitation treatments to improve the quality of life and increase the quality of urination for patients with neurogenic bladder. Both aim to enhance the patient's bladder capacity, reduce residual urine volume, and decrease the incidence of urinary incontinence. However, there is no consensus on the therapeutic effect of comprehensive bladder management combined with biofeedback stimulators for patients with neurogenic bladder.

This study aims to investigate the safety and effectiveness of bladder comprehensive management combined with a biofeedback stimulator for rehabilitation treatment in patients with neurogenic bladder. In this study, the experimental group underwent a step-by-step implementation of bladder comprehensive management combined with biofeedback stimulator therapy. The treatment was evaluated based on changes in bladder capacity, incidence of urinary incontinence, residual urine volume, and the responses on the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF).

The results showed significant improvements in all parameters for both groups, with the treatment group achieving superior outcomes. Bladder capacity increased (212.37 ± 45.56 mL to 350.98 ± 93.52 mL), urinary incontinence incidence decreased (46.43% to 7.14%), residual urine volume reduced (149.25 ± 12.25 mL to 49.63 ± 6.96 mL), and ICIQ-SF scores improved (14.12 ± 3.55 to 5.95 ± 2.26). These findings highlight the combined therapy's effectiveness in improving bladder function and reducing incontinence.

Introduction

Neurogenic Bladder (NB), as a complex urologic disorder, is rooted in the impairment of bladder function by central or peripheral nervous system pathology¹. The danger of the neurogenic bladder goes far beyond the physical level; it is more like a silent storm that severely erodes the mental health and social life of the patients, ultimately leading to a drastic reduction in the quality of life². It should not be overlooked that the global aging of the public and the steady rise in the morbidity of strokes and other diseases of the nervous system have contributed to the annual increase in the prevalence of NB, which has ....

Protocol

This protocol has been approved by the Ningbo Yinzhou No.2 Hospital (project number: 2023 Scientific Research 002). All patients provided written informed consent for participation in this study, including the use and publication of their anonymized data per the ethical guidelines outlined in the approved protocol. Details of instruments for biofeedback electrical stimulation can be found in the Table of Materials.

1. Study design

1. Ensure that the study is single-blind: only researchers will be aware of group assignments.
2. Random grouping: Stratify the patients according to their key characteristics (age....

Results

In this study, 56 patients were enrolled, with 28 cases in each group. The control group (received standard bladder rehabilitation care) included 15 males and 13 females, with an average age of 56.32 ± 13.52 years and a disease duration of 42.62 ± 18.54 months. The treatment group (received a combination of CBM and biofeedback stimulator therapy) had 28 cases, including 16 males and 12 females, with an average age of 57.36 ± 12.52 years and a disease duration of 45.65 ± 17.74 months (

Discussion

Neurogenic bladder (NB) and comprehensive treatment: A CBM program combined with a biofeedback stimulator offers a multi-faceted therapeutic mechanism in NB rehabilitation.

Multiple approaches of bladder management

A CBM program enhances bladder function using medication, bladder training, and intermittent catheterization. Medications such as anticholinergic drugs and alpha-blockers help alleviate overactive bladder symptoms¹⁹

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Biofeedback Stimulator	Suji Injection Standard 20030029	Biofeedback stimulator treatment mechanism: The use of time-varying magnetic fields to generate induced currents in tissues, so as to depolarize cells to produce action potentials, which can induce muscle contraction, promote the recovery of nerve function, and produce a series of physiological and biochemical reactions, so as to improve physiological function. Improvement of pelvic floor muscle function by a biofeedback stimulator. By repeatedly activating the terminal motor nerve fibers and the motor endplate, the pelvic floor muscles contract, and at the same time promote the pelvic floor blood circulation and increase the number of fiber recruitment. More effective stimulation of the deep pelvic floor muscles, thereby improving the pelvic floor muscles. The biofeedback stimulator can be applied to postpartum pelvic floor rehabilitation, pelvic organ prolapse, stress urinary incontinence, defecation dysfunction, mixed urinary incontinence, sexual dysfunction, chronic pelvic pain, etc.
Statistical Package For the Sciences(SPSS)26.0	IBM Corporation	Used for statistical analysis?including t-tests?multiivariate regression?and anallysis of covariance