Effects of magnetic stimulation on neurogenic lower urinary tract dysfunction in patients with spinal cord injury: A systematic review and meta-analysis
Guan-Ru Ho, Kai-Hsiang Liang, Luo-Hua Yu, Yi-Shiung Horng
A
BSTRACT
Objectives:
Neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI) imposes a major burden and existing conservative treatments often provide suboptimal control.
Materials and Methods:
This study provides the most up-to-date systematic review and meta-analysis to evaluate the efficacy of magnetic stimulation (MS) for SCI-related NLUTD. Ovid Medline, Ovid Embase, Cochrane Library, Web of Science, ClinicalTrials.gov, China National Knowledge Infrastructure, and Airiti Library were searched for randomized controlled trials comparing MS with sham stimulation or conventional management.
Results:
Nineteen trials involving 965 participants were included. Compared with control, MS significantly reduced postvoid residual urine (standardized mean difference [SMD]: −1.28, 95% confidence interval [CI]: −1.68 to − 0.88) and micturition frequency (SMD: −1.01, 95% CI: −1.52 to − 0.50) and increased maximum cystometric capacity (MCC; SMD: 0.59, 95% CI: 0.15 to 1.04), single voided volume (SMD: 2.18, 95% CI: 1.16 to 3.20), and maximum urine flow rate (SMD: 1.23, 95% CI: 0.72 to 1.75). Crucially, advanced subgroup analysis revealed a type-specific response: for lower motor neuron type, cranial stimulation failed to increase MCC (SMD: −0.33,
Conclusion:
MS appears to improve key urodynamic parameters in SCI-related NLUTD. Crucially, therapeutic potential may be maximized when the stimulation site is tailored to the specific NLUTD phenotype. However, substantial between-study heterogeneity indicates that further rigorously designed trials are required to define optimal stimulation protocols and long-term effects.