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

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