Transvertebral and transcranial magnetic neuromodulation in the treatment of detrusor underactivity: 6 months follow up

Kovalev G1, Labetov I1, Smagulov A1, Myrzalieva S1, Berdichevskaya A1, Loginov I2, Maslyukova A2, Loginova M2, Smirnov N2

Research Type

Clinical

Abstract Category

Continence Care Products / Devices / Technologies

Abstract 874
Open Discussion ePosters
Scientific Open Discussion Session 105
Friday 19th September 2025
13:45 - 13:50 (ePoster Station 4)
Exhibition
Voiding Dysfunction Neuromodulation New Devices Detrusor Hypocontractility
1. Scientific and Clinical Center of Neurourology, Saint Petersburg, Moscow, Russian Federation/Almaty Kazakhstan, 2. Ivanovo State Medical Academy, Ivanovo, Russia
Presenter
G

Gleb Kovalev
Scientific and Clinical Center of Neurourology, Saint Petersburg, Moscow, Russian Federation/Almaty Kazakhstan
Links

Poster

Abstract

Hypothesis / aims of study 
Detrusor underactivity is one of the most challenging issue in neuro-urology Its etiology often remains unclear and current treatment options frequently fail to meet the expectations of both patients and physicians.

The aim of the study was to evaluate the effectiveness of trans cranial and trans vertebral neuromodulation in treating detrusor underactivity.
Study design, materials and methods 
The study included 26 patients. The treatment course consisted of 20 procedures (performed four times a week for five weeks). Transcranial neuromodulation was conducted twice a week, and trans vertebral neuromodulation was also performed twice a week. The transcranial stimulation protocol involved a figure eight coil targeting the supplementary motor area, with continuous stimulation at 20 Hz for 15 minutes. The trans vertebral neuromodulation protocol used a figure eight coil targeting the sacral spinal cord zone S2 to S4, with continuous stimulation at 20 Hz for 25 minutes. Subjective complaints were assessed before and after treatment at 1, 3, and 6 months. Objective indicators were evaluated using multi channel urodynamic studies before treatment and at 6 months post treatment.
Results 
A significant improvement in the subjective condition of patients was achieved at all stages of observation. All patients included in the study underwent a full course of neuromodulation. Six patients chose to resume independent urination instead of relying on intermittent catheterization. Magnetic neuromodulation had the greatest impact on such urodynamic parameters as the first feeling of filling, the first feeling of urge, residual volume, and maximum cystometric capacity The detrusor contractility index increased from an average of 11.9 before treatment to 22.8 cm H2O after treatment.
Interpretation of results 
The study demonstrated a significant therapeutic benefit of combined trans vertebral and trans cranial magnetic neuromodulation in patients with detrusor underactivity.
Concluding message 
However, further large scale, placebo controlled studies are necessary to develop universally effective protocols for the treatment of lower urinary tract dysfunctions.
Figure 1 Figure 1 (A,B) Positioning of figure eight coil for transcranial and transvertebral neuromodulation. A: stimulation of the supplementary motor area
Figure 2 Figure 1B: stimulation of the sacral spine
Figure 3 Table 1 presents the urodynamic parameters before and 6 months after treatment.
Figure 4 Figure 2A. Bladder contracline was determined using multichannel urodynamics on the «UroSmart» (А) urodynamic system
Figure 5 Figure 2B: with a built in Rivus uroflowmeter (Neurosoft) (B)
Disclosures
Funding Neurosoft Clinical Trial Yes Public Registry No RCT No Subjects Human Ethics Committee Scientific and Clinical Center of Neurourology, Saint Petersburg, Moscow Helsinki Yes Informed Consent Yes
22/07/2025 06:42:13