Combined Magnetic Stimulation and Ultrasound for Detrusor Overactivity in SCI

Researchers will combine high-frequency sacral nerve root magnetic stimulation with bladder ultrasound therapy and compare this combination against magnetic stimulation alone (with sham ultrasound) to determine whether the combined approach provides added benefit.

Participants will:

Receive either sacral nerve root magnetic stimulation, bladder ultrasound therapy, or the combination of both, once daily for 3 consecutive weeks (7 sessions per week).

Attend the hospital for urodynamic testing (to assess safe bladder capacity, storage pressure, and compliance) and urinary tract ultrasound (to evaluate bladder wall thickness and upper urinary tract structure) before the treatment and after the 3-week intervention.

Maintain a voiding diary for at least 3 consecutive days (recording single voided volumes, urgency scores, and incontinence episodes), and complete validated questionnaires on lower urinary tract symptoms and quality of life.

Inclusion criteria

• Diagnosis of spinal cord injury (SCI) above the sacral level according to the International Standards for Neurological Classification of Spinal Cord Injury (revised 2011), confirmed by CT or MRI;
• Detrusor overactivity confirmed by urodynamic study;
• No severe urinary system diseases such as tumors, stones, infection, or organic urinary tract obstruction;
• No severe hepatic/renal insufficiency, pulmonary, or cardiovascular diseases;
• Aged 18-80 years;
• Able to understand and comply with the required examinations, rehabilitation assessments, and treatment, and provide written informed consent.

Exclusion criteria

• Unstable vital signs or critically ill condition;
• Severe autonomic dysreflexia;
• Presence of metallic implants within 10 cm of the magnetic stimulation treatment area;
• Any other diseases or conditions that may interfere with the study outcomes.