Treatment of detrusor instability with cordless transcutaneous electrical nerve stimulation

Introduction: Transcutaneous electrical nerve stimulation (TENS) has been shown to improve symptoms and urodynamic findings in certain patients with detrusor instability (DI). The efficacy, convenience and patient acceptability of a small self-contained, adhesive cordless TENS machine has been evaluated in a prospective urodynamic study. Patients and methods: Fourteen patients with severe proven DI who had failed conventional anticholinergic agents were recruited and underwent a 4-week trial using the cordless machine. The efficacy was evaluated using urodynamic testing performed before and after treatment and by frequency voiding charts. The patients' perception of the acceptability and ease of use of the machine was assessed using a questionnaire. Results: There was an increase of 25% in bladder capacity at the first unstable contraction (P < 0.05). Two patients reported that they were 'much improved' and dry; seven reported minor improvements and six said there was no change. In nine, daytime frequency and urgency improved. Two patients have purchased their own machine for long-term use. Conclusions: TENS therapy with this small cordless machine was acceptable to patients and resulted in marked improvement in a minority, although half reported minor improvements; some urodynamic benefit was noted. In patients with severe DI who have failed conventional anticholinergic treatment, a trial of TENS with this small cordless device should be carried out before more major intervention is considered. © 1997 British Journal of Urology.