Stimulation of the Dorsal Genital Nerve (DGN) is a promising and emerging treatment for both OAB and BD. Research has demonstrated a reduction in incontinence episodes in 79% of patients with OAB using a percutaneous placed electrode for 1 week. Another study showed that by using 30 seconds of on-demand stimulation in patients with OAB allowed the patients to reach the toilet before leaking elsewhere. Further, it was shown that DGN stimulation led to increased bladder capacity and reduction in incontinence episodes. Similar, research has demonstrated a significant reduction in number of fecal incontinence episodes, together with a significant decrease in the overall number of bowel movements both with and without urgency in BD patients utilizing 2x15 minutes DGN stimulation per day. The improvement in symptoms was still present 3 weeks after stimulation.

DGN stimulation has the advantage over similar neuromodulation as it can be applied externally at the genitals allowing easy application and removal. Other devices often require surgical implantation, which has a higher cost and carries greater risk of complications. DGN stimulation has never been implemented clinically, as no acceptable electrodes specifically designed for DGN stimulation exists. Therefore, a device which can treat OAB and BD by activating DGN by external stimulation will bring more affordable and less invasive treatment options for the patients.

A total of 40 participants ≥ 18 years of age showing symptoms of OAB/BD are to receive the treatment (plaster stimulation at the root of penis/clitoris). 6 weeks treatment. Frequency volume chart and questionnaires.

The project is done as a collaboration between Department of surgery, urogynecology and urology in Pelvic Floor Unit

Contact: graugaard@clin.au.dk

Bladder pain syndrome (BPS) is defined as a persistent or recurrent chronic pelvic pain, pressure or discomfort perceived to be related to the urinary bladder accompanied by at least one other urinary symptom such as an urgent need to void or urinary frequency. The duration must be 6 month or more.  Reports of BPS prevalence have varied greatly, along with the diagnostic criteria and populations studied. Recent reports range from 0.06 to 30% with female predominance and is a disease that negatively impacts quality of life with more anxiety, depression, and psychosocial setbacks than aged-matched controls.

We are conducting a small-scale study with Pentosan polysulfate which already is approved and marketed as treatment to patients diagnosed with BPS. The purpose of this small-scale study is to evaluate the feasibility of pentosan polysulfate in the treatment of BPS prior to full-scale implementation of the treatment in a clinical setting. Patients are treated three times a day for 6 month and are followed 9 months in total.

Contact: graugaard@clin.au.dk

Urine retention postoperative (POUR) is often seen after lower back surgery but also in patients undergoing orthopaedic alloplastic surgery. It can be due to the anaesthesia during the operation or the treatment with Opioids postoperatively.  Urine retention can however also be aggravated if the patient for example due to BPH has a large amount of residual urine preoperatively.

All male patients undergoing lower-back surgery, a hip-or knee alloplastic will have a bladder scan pre- and postoperatively. Patients with residual urine below 150 ml pre-and postoperatively (group 1) will be signed out of the department without further urologic examination. Patients with residual urine between 150 and 300 ml (group 2) will be recommended to visit their GP for follow-up. Patients with residual urine above 300 ml (group 3) will be referred to Department of Urology.

6 months after surgery, patients from group 2 and 3 fulfill questions concerning their urological health, ICIQ Male LUTS questionnaire and a questionnaire concerning Quality of life.

The project is done as a collaboration between Center for elective surgery, Silkeborg and Department of Urology, Gødstrup

Contact: graugaard@clin.au.dk