Multilevel magnetic stimulation in the treatment of neurogenic pelvic organ dysfunction in patients with spinal cord injury

Each year, 35–40 million cases of spinal cord injury (SCI) are registered worldwide. Among these, 80–100% of patients become disabled or die. In 20% of cases, disability results from neurogenic pelvic organ dysfunction (urination and defecation disorders). This study assessed the effectiveness of multilevel magnetic stimulation (MMS), which combines peripheral, spinal, and transcranial rhythmic magnetic stimulation techniques, in patients with SCI and neurogenic pelvic dysfunction. A total of 30 patients with traumatic SCI were examined. The control group (n=15) received standard therapy, while the experimental group (n=15) additionally underwent MMS. The results showed that MMS was most effective in patients with thoracic spinal cord injuries, demonstrating significant improvements in urinary outflow (p=0.024), bladder filling function (p=0.020), and compensation of urination according to the O. A. Perlmuter’s scale (p=0.038). No statistically significant improvement was observed in the control group. These findings suggest that MMS is a promising method for the rehabilitation of neurogenic pelvic dysfunction in patients with SCI.

1. Yip P. K., Malaspina A. Spinal cord trauma and the molecular point of no return. Molecular Neurodegeneration. 2012; 7: 1–10. DOI: 10.1186/1750‑1326‑7‑6

2. Porada N. E. Public health and healthcare: a course of lectures. Minsk: IVC of the Ministry of Finance, 2017. 126 p. ISBN 978‑985‑7168‑08‑8. (In Russ.).

3. Diseases and injuries of the nervous system / I. V. Litvinenko, V. Yu. Lobzin, N. V. Tsygan [and others]. Military field therapy: national guidelines / edited by E. V. Kryukov. 2nd ed., revised and additional M.: GEOTAR-Media, 2023. P. 542–565. (In Russ.).

4. Spinal Neurology: textbook / G. O. Andreeva, S. N. Bazilevich, G. N. Bisaga [et al.]. St. Petersburg: SpetsLit, 2017. 430 p. ISBN 978‑5‑299‑00886‑9. (In Russ.).

5. Epidemiology of vertebral and spinal cord injuries (review) / V. S. Tolkachev [et al.]. Saratov Scientific Medical Journal. 2018; 14 (3): 592–595. (In Russ.).

6. Novoselova I. N. Etiology and clinical epidemiology of spinal cord injury. A literary review. Russian Neurosurgical Journal named after prof. A. L. Polenov. 2025; 11 (4): 84–92. (In Russ.).

7. Nervous diseases: a textbook for students of medical universities / edited by M. M. Odinak, I. V. Litvinenko. St. Petersburg: SpetsLit, 2020. 575 p. ISBN 978‑5‑299‑01025‑1. (In Russ.).

8. Combat pathology of the nervous system. A brief guide for military doctors: study guide / ed. by I. V. Litvinenko. SPb.: VMedA, 2023. 80 p. (In Russ.).

9. Benevento B. T., Sipski M. L. Neurogenic bladder, neurogenic bowel, and sexual dysfunction in people with spinal cord injury. Physical Therapy. 2002; 82 (6): 601–612. DOI: 10.1093/ptj/82.6.601

10. Mazo E. B., Krivoborodov G. G. Overactive bladder. Consilium Medicum. 2003; 5 (7): 405–411. (In Russ.).

11. The standardization of terminology of lower urinary tract function: report from the standardization sub-committee of International Continence Society / Abrams P., Cardozo L., Fall M. [et al.]. Textbook of Female Urology and Urogynecology. Boca Raton: CRC Press, 2010. P. 1098–1108. ISBN 978‑1‑003‑03998‑3.

12. Krasyukov A. V. Disorders of the autonomic nervous system associated with spinal cord injury. Scientific review. Russian Journal of Neurosurgery. 2014; 6 (3): 85–101. (In Russ.).

13. Extracorporal magnetic stimulation of the neuromuscular apparatus of the pelvic floor in urological practice / D. Yu. Pushkar, A. V. Sivtsov, D. V. Bredikhin [et al.]. Physiotherapy, balneology and rehabilitation. 2019; 18 (4): 264–276. (In Russ.).

14. Efimova E. P. Application of magnetic fields in medicine. Physics and Medicine: Creating the future. 2017. P. 58–61. (In Russ.).

15. Cortical, spinal, sacral, and peripheral neuromodulations as therapeutic approaches for the treatment of lower urinary tract symptoms in multiple sclerosis patients: A review / Pericolini M., Germani G., Galli S. [et al.]. Neuromodulation: Technology at the Neural Interface. 2022; 25 (8): 1065–1075. DOI: 10.1111/ner.13525

16. Non-invasive activation of cervical spinal networks after severe paralysis / Gad P., Choe J., Nandra M. S. [et al.]. Journal of Neurotrauma. 2018; 35 (18): 2145–2158. DOI: 10.1089/neu.2017.5461

17. Non-invasive neuromodulation of spinal cord restores lower urinary tract function after paralysis / Gad P. N., Choe J., Shah P. K. [et al.]. Frontiers in Neuroscience. 2018; 12: 432. DOI: 10.3389/fnins.2018.00432

18. Effects of motor cortex rTMS on lower urinary tract dysfunction in multiple sclerosis / Centonze D., Petta F., Versace V. [et al.]. Multiple Sclerosis Journal. 2007; 13 (2): 269–271. DOI: 10.1177/1352458506070729

19. A proof-of-concept study of transcutaneous magnetic spinal cord stimulation for neurogenic bladder / Niu T., Munakomi S., Jiang H. [et al.]. Scientific Reports. 2018; 8 (1): 12549. DOI: 10.1038/s41598‑018‑30958‑2

20. Dynamics of pelvic function indicators in patients with spinal cord injury as a result of spa treatment / A. G. Stoporov, E. A. Vinogradova, I. S. Kovalyov [et al.] // Bulletin of Physiotherapy and Balneology. 2018; 24 (4): 20–25. (In Russ.).

21. Perlmutter O. A. Compression of the spinal cord and its roots: Abstract of the dissertation of the Doctor of medical sciences / O. A. Perlmutter. M., 2000. 46 p. (In Russ.).