Home Neuromodulation of the Neurogenic Bladder in Chronic Spinal Cord Injury With Transcutaneous Tibial Nerve Stimulation

Home Neuromodulation of the Neurogenic Bladder in Chronic Spinal Cord Injury With Transcutaneous Tibial Nerve Stimulation

Determine the safety, feasibility, compliance, and efficacy of a daily home TTNS protocol in chronic SCI provided by self or caregiver for 4 weeks.

In Specific Aim 1, we will monitor for safety, feasibility, and compliance of a home TTNS program for bladder management. In Specific Aim 2, the efficacy of home TTNS will be compared to baseline Incontinence- Quality of Life questionnaire. A bladder diary will also capture important information such as frequency and volume of catheterization, incontinence episodes, and other related observations.

Inclusion Criteria:

• 18-65 years old
• Neurologically stable SCI for ≥ 6 months
• Intermittent catheterization to empty bladder
• Stable bladder medications for ≥ 3 months

Exclusion Criteria:

• Multiple medications for the bladder
• Other diagnoses to explain incontinence (ex: UTI, bladder stones, multiple sclerosis, etc.)
• 2+ pitting edema that does not resolve
• Known peripheral neuropathy or injury to the path of the tibial nerve
• Demand-type cardiac pacemaker or implanted defibrillator
• Cancer in the tibial nerve path and/or bladder
• Inability to elicit toe/plantar flexion with electric stimulation during the clinic visit.
• Inability to understand directions
• Non-English speaking