ABSTRACT
The first intravesical electrical stimulation (IVES) trial can be traced back to 1878 when the Danish surgeon Saxtorph treated patients with urinary retention by transurethral bladder stimulation. This technique was reintroduced by the Hungarian neurosurgeon Katona as a treatment for neurogenic voiding disorders. One of the major problems in applying IVES might be that each practitioner has his/her own protocol, which is not standardized. IVES has been implemented not only for initiating sensory awareness of bladder filling and stimulating detrusor contraction but also for increasing bladder capacity at a constantly low pressure in children with neurogenic bladder, mostly secondary to spina bifida. The exact mechanism of how neuromodulation works is not completely understood, but several studies have investigated the anatomical and physiological aspects of IVES. The primary treatment approaches in neurogenic bowel management in children with meningomyelocele include dietary modification, timed toileting, biofeedback, and use of stool softeners and enema.
