Post-stroke urinary retention is a common complication with important clinical consequences. Supraspinal control of micturition involves cortical and corticopontine circuits, and neuromodulation has been proposed as a strategy to influence bladder control after brain injury. The authors evaluated whether repetitive transcranial magnetic stimulation (rTMS) applied to the contralesional primary motor cortex (M1) could modulate supraspinal micturition pathways and improve bladder emptying in patients with post-stroke urinary retention.
This was a retrospective cohort study that included 103 patients diagnosed with post-stroke urinary retention. Participants were allocated to one of two groups based on the treatment received: 52 patients received rTMS plus rehabilitation and 51 received rehabilitation alone. The authors report that most baseline characteristics were similar between the two groups. No randomization or blinding is reported in the abstract; the design is therefore observational and retrospective in nature.
Patients in the intervention group underwent 4 weeks of low-frequency rTMS targeted to the contralesional M1, combined with standard rehabilitation. The abstract specifies the duration (4 weeks) and the stimulation site (contralesional primary motor cortex) and characterizes the rTMS as low-frequency, but it does not report specific stimulation parameters (for example frequency in Hz, number of pulses, intensity relative to motor threshold, session frequency per week) in the abstract.
The control group received rehabilitation alone for the same general period. The abstract does not provide details of the rehabilitation program components, intensity, or duration beyond stating that rehabilitation was provided, nor does it report whether rehabilitation content was standardized between groups.
Primary and secondary outcomes reported in the abstract include changes in post-void residual (PVR) volume and exploratory analysis of a urinary function score. In addition, neurophysiological measures were obtained: reflex latency and electromyography (EMG) amplitude. These neuroelectrophysiological endpoints were used to assess potential supraspinal modulation of micturition circuits associated with the intervention.
The abstract reports that the rTMS group experienced greater improvements in bladder emptying and neurophysiological indices compared with the rehabilitation-only group. Specific findings reported were:
Change in PVR: at week 2 the median or mean reduction reported was -30 ml for the rTMS group versus -10 ml for controls; at week 4 the change was -64 ml versus -17 ml (difference between groups reported with p < 0.001).
Urinary function score (exploratory): greater improvement in the rTMS group (-6.1) compared with controls (-2.1), p < 0.001.
Reflex latency: a shortening in reflex latency was observed with rTMS (-14.4 ms) versus a smaller change in controls (-5.0 ms), p < 0.001.
EMG amplitude: EMG amplitude increased more in the rTMS group (+23.4 µV) than in controls (+2.5 µV), p < 0.001.
The abstract emphasizes statistically significant differences favoring rTMS across these measured outcomes. The exact statistical methods, measures of variance (for example SD or IQR), and whether analyses adjusted for potential confounders are not detailed in the abstract.
Within this retrospective cohort, low-frequency rTMS delivered to the contralesional M1 and combined with rehabilitation was associated with greater reductions in PVR and improvements in an exploratory urinary function score compared with rehabilitation alone. The rTMS group also demonstrated neuroelectrophysiological changes consistent with modulation of neural circuits involved in bladder control, specifically shorter reflex latency and larger EMG amplitude.
Because the study design is retrospective and observational, the results describe associations rather than definitive causal effects. The abstract notes that most baseline characteristics were similar between groups but does not report how potential confounders were controlled or whether there were differences in concomitant treatments. Details commonly sought for interpretation—such as exact stimulation parameters, rehabilitation protocol specifics, patient selection criteria, baseline PVR values, duration since stroke, and adverse events—are not provided in the abstract and therefore were not reported in the source summary.
The study received approval from the Institutional Ethics Committee of People’s Hospital of Anshun City (Approval No. 2025018). All participants provided written informed consent prior to inclusion, and the study was conducted in accordance with the Declaration of Helsinki. The authors declared no competing interests in the conflict of interest statement.
Note: This summary and the detailed sections above reflect only the information reported in the PubMed/NCBI abstract and associated metadata. The abstract provides key group-level outcomes and neurophysiological findings but omits several methodological and safety details that would be required for a complete critical appraisal of efficacy and generalizability.