Using Epidural Spinal Cord Stimulation and Pelvic Floor Muscle Training to Improve Bladder and Bowel Function After Spinal Cord Injury

What this Trial Is About

This research aims to improve pelvic rehabilitation for adults with chronic, supra-sacral spinal cord injury SCI by evaluating the use of epidural spinal cord stimulation eSCS combined with pelvic floor muscle training. Up to 20 volunteers will participate, all having confirmed neurogenic detrusor overactivity NDO and responsiveness to dorsal genital nerve stimulation. The study focuses on assessing bladder, bowel, sexual function, quality of life, motor function, and spasticity over time. The study includes two main phases. In Phase I, participants will have a Senza implantable pulse generator placed under the skin, with electrodes positioned to target bladder, bowel, and pelvic floor muscles. Mapping sessions will identify effective stimulation settings for home use. Participants will learn pelvic floor muscle exercises to perform alongside eSCS. Phase II involves a 12-week home trial using these stimulation programs and exercises, with regular clinic visits and weekly phone calls for support and progress review. Participants will undergo extensive assessments including urodynamics, anorectal physiology, bladder and bowel diaries, and various questionnaires before and after the intervention, as well as at 3 and 6 months follow-up. They will be offered the choice to keep or have the eSCS device removed after the trial. Researchers will continue to monitor all participants long-term to evaluate changes in bladder capacity and other key outcomes, ensuring comprehensive safety and effectiveness tracking throughout the study period.

Improving Pelvic Rehabilitation Using Epidural Stimulation After Spinal Cord Injury