THE EXPERIENCE OF NERVE BLOCKS IN THE MANAGEMENT OF URINARY INCONTINENCE

Abstract

Fifteen patients with severe urinary incontinence, whose vesical function was characterized by uninhibited detrusor contraction and poor compliance, were subjected to nerve blocking procedures.
Cure of incontinence was obtained in 14 while the remaining one was rendered to mild stress incontinence.
Vesical function after the nerve blocks showed the following changes.
a) increase in bladder capacity+200% by subarachnoidal block+127% by caudal block and+91% by bilateral S₃ block,
b) suppression of uninhibited detrusor contractions and
c) increase in bladder compliance.
Although electromyography potential after block became silent in 50% of subarachnoidal block cases, generally it was maintained well above 100μV in the rest and after caudal and S₃ blocks.
Reduction in maximal urethral colsing pressure was also small in the most of the examined. These features seem to speak for good response to nerve blocks seen in these patients.
Indications and side effects of each procedure are discussed. These blocks are recommended as simple, and reliable methods in the management of severe urinary incontinence.