Effects of non-invasive or minimally invasive neuromodulation techniques on neurogenic lower urinary tract dysfunction after spinal cord injury: A network meta-analysis.

Objective: To assess the available evidence of non-invasive or minimally invasive neuromodulation therapies in improving urodynamic outcomes, voiding diaries, and quality of life in patients with neurogenic lower urinary tract dysfunction (NLUTD) after spinal cord injury (SCI).

Data Sources: A comprehensive search of 10 databases from inception until August 30, 2023 was conducted.

Study Selection: Randomized controlled trials (RCTs) assessing the effects of conventional treatment (CT) and CT combined with sham stimulation (SS), transcranial magnetic stimulation (TMS), sacral nerve magnetic stimulation (SNMS), TMS+SNMS, sacral pulsed electromagnetic field therapy (SPEMFT), sacral transcutaneous electrical nerve stimulation (STENS), sacral dermatomal transcutaneous electrical nerve stimulation (SDTENS), bladder & sacral transcutaneous electrical nerve stimulation (B&STENS), transcutaneous tibial nerve stimulation (TTNS), transcutaneous electrical acupoint stimulation (TEAS), pelvic floor electrical stimulation (PFES), or pelvic floor biofeedback therapy (PFBFBT) on postvoid residual volume (PVR), maximum cystometric capacity (MCC), number of voids per 24 h (V24), mean urine volume per micturition, (MUV), maximum urinary flow rate (Qmax), maximum detrusor pressure (MDP), maximum voiding volume (MVV), number of leakages per 24 h (L24), lower urinary tract symptoms (LUTS) score, and spinal cord injury-quality of life (SCI-QoL)score in patients with NLUTD after SCI were included.