Short-term Genital Nerve Stimulation to Modulate Anorectal Reflex Activity in Neurogenic Bowel Dysfunction in Individuals Living With Spinal Cord Injury

What this Trial Is About

Bowel problems, including fecal incontinence, are common and challenging for people living with spinal cord injury (SCI). This research evaluates the effects of genital nerve stimulation (GNS) using non-invasive electrodes on the function of the anus and rectum in individuals with SCI. The study aims to understand how GNS may influence bowel control by measuring anorectal manometry (ARM) outcomes and collecting detailed medical and bowel function information to predict who might benefit from this approach. Participants will undergo two possible visits. The first visit involves screening, informed consent, and brief GNS to determine nerve responsiveness. Those who respond will be invited for a second visit involving ARM testing with and without GNS using a specific protocol (no stimulation, stimulation, no stimulation repeated). This includes insertion of a catheter and electrode placement to record anorectal reflexes and function. The study randomizes participants to receive either sham or effective stimulation first to balance order effects. During participation, individuals will provide bowel program history, complete surveys about bowel function and quality of life, and undergo neurological and clinical exams. Researchers will measure ARM outcomes such as rectal wall tension, anal sphincter function, and reflex activity up to three weeks after enrollment. Transportation and lodging support are available to reduce barriers. The total time commitment is about 7.5 hours across one or two visits.

Acute Genital Nerve Stimulation for Neurogenic Bowel Dysfunction in Individuals Living With Spinal Cord Injury