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More MS news articles for March 2003

Lower abdominal pressure versus external bladder stimulation to aid bladder emptying in multiple sclerosis: a randomized controlled study

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12617378&dopt=Abstract

Clin Rehabil 2003 Feb;17(1):42-7
Prasad RS, Smith SJ, Wright H.
Neurorehabilitation Unit, Astley Ainslie Hospital, Edinburgh, Scotland, UK.

OBJECTIVE:

To investigate the change in post-void residual bladder volumes (PVR) with 'abdominal vibration' using a percutaneous bladder stimulator in multiple sclerosis (MS) patients compared with either 'no treatment' or 'abdominal pressure'.

DESIGN:

Randomized controlled cross-over study.

SETTING:

Regional neurorehabilitation clinics.

SUBJECTS:

Twenty-eight MS patients with urinary symptoms and PVR > 100 ml.

Twelve patients had urinary incontinence.

METHODS:

MS patients with voiding dysfunction and elevated PVR of 100-500 ml on BVI-3000 Ultrasound Scanner were randomized to either 'abdominal pressure' or 'vibration' by a portable, percutaneous, vibrating device (Queen Square Bladder Stimulator; Malem Medical) or to 'no treatment'.

PVR was assessed at the end of each two-week phase.

Outcome measure: PVR reduction by greater than 100 ml.

RESULTS:

The 28 patients ranged in age from 29 to 71 years with a mean age of 49 years and a mean duration of MS of 12 years (range 1-37 years).

The PVR decreased from 231 (SD 119) ml during no treatment to 191 (SD 132) ml with abdominal pressure (p = 0.242).

Using suprapubic vibration the PVR reduced further to 126 (SD 121) ml, which was highly significant (p = 0.002) compared with no treatment.

The difference between abdominal pressure and vibration just failed to reach significance (p = 0.059).

There was no significant reduction in either the frequency of micturition or episodes of incontinence.

The device was well-tolerated by patients.

CONCLUSION:

Abdominal vibration is an effective method of reducing PVR in MS patients and appears more effective than abdominal pressure alone.