Effects of pudendal neuromodulation on bladder function in chronic spinal cord-injured rats

被引:5
作者
Lin, Yin-Tsong [1 ,2 ,3 ]
Hsieh, Tsung-Hsun [4 ,5 ,6 ,7 ]
Chen, Shih-Ching [2 ,8 ]
Lai, Chien-Hung [2 ,8 ]
Kuo, Te-Son [3 ,9 ,10 ]
Chen, Chung-Ping [3 ,9 ]
Lin, Chii-Wann [3 ,9 ,10 ]
Young, Shuenn-Tsong [11 ]
Peng, Chih-Wei [1 ,2 ,8 ,12 ]
机构
[1] Taipei Med Univ, Grad Inst Biomed Mat & Tissue Engn, Coll Biomed Engn, Taipei, Taiwan
[2] Taipei Med Univ, Dept Phys Med & Rehabil, Sch Med, Coll Med, Taipei, Taiwan
[3] Natl Taiwan Univ, Grad Inst Biomed Elect & Bioinformat, Taipei, Taiwan
[4] Taipei Med Univ, Grad Inst Neural Regenerat Med, Taipei, Taiwan
[5] Chang Gung Univ, Dept Phys Therapy, Taoyuan, Taiwan
[6] Chang Gung Univ, Grad Inst Rehabil Sci, Coll Med, Taoyuan, Taiwan
[7] Chang Gung Univ, Hlth Aging Res Ctr, Taoyuan, Taiwan
[8] Taipei Med Univ Hosp, Dept Phys Med & Rehabil, Taipei, Taiwan
[9] Natl Taiwan Univ, Dept Elect Engn, Taipei, Taiwan
[10] Natl Taiwan Univ, Inst Biomed Engn, Taipei, Taiwan
[11] Mackay Med Coll, Holist Educ Ctr, New Taipei, Taiwan
[12] Taipei Med Univ, Coll Biomed Engn, Sch Biomed Engn, 250 Wuxing St, Taipei 11031, Taiwan
关键词
electrical stimulation; intravesical pressure; pudendal nerve; spinal cord injury; voiding efficiency; URETHRAL SPHINCTER ACTIVITY; LOWER URINARY-TRACT; RECEPTOR AGONIST 8-OH-DPAT; OVERACTIVE BLADDER; ELECTRICAL-STIMULATION; DETRUSOR INSTABILITY; NEUROGENIC BLADDER; REFLEX MICTURITION; VOIDING EFFICIENCY; COMPONENT REFLEXES;
D O I
10.1016/j.jfma.2015.07.010
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background/Purpose: Few studies have investigated the feasibility of using pudendal neuromodulation to regulate bladder function in spinal cord-injured (SCI) animals. The present study aimed to determine the effects of electrical activation of the pudendal sensory branch on improving voiding functions in rats 6 weeks after a spinal cord injury and to explore the underlying neuromodulatory mechanisms. Methods: Two urodynamic measurements were used to assess the effects of electrical stimulation (ES) on bladder and urethral functions: simultaneous recordings of the intravesical pressure (IVP) during continuous isotonic transvesical infusion (i.e., isotonic IVP) and external urethral sphincter (EUS) electromyography (EUS-EMG), and simultaneous recordings of transvesical pressure under isovolumetric conditions (i.e., isovolumetric IVP) and urethral perfusion pressure (UPP). Results: Six weeks after the SCI, the rats showed voiding dysfunction, as indicated by abnormal cystometric measurements (e.g., increased volume threshold, increased contraction amplitude, and increased residual volume, and decreased voided volume). The voiding efficiency (VE) decreased to 13% after the SCI, but increased to 22-34% after applying pudendal afferent stimulation. In addition, pudendal stimulation significantly increased the EUS burst period and increased the difference between the UPP and the high-frequency oscillation (HFO) baselines, and changed the time offset between bladder and EUS activities. These findings suggest that pudendal afferent stimulation improved the VE by prolonging the micturition interval, decreased the urethral resistance, and recovered detrusor-sphincter dyssynergia during the voiding phase. Conclusion: This study demonstrates the feasibility of using pudendal neuromodulation in chronic SCI rats. These results could aid in developing an advanced neural prosthesis to restore bladder function in clinical settings. Copyright (C) 2015, Formosan Medical Association. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license.
引用
收藏
页码:703 / 713
页数:11
相关论文
共 44 条
[1]  
ANDERSON KE, 1993, PHARMACOL REV, V45, P253
[2]   The effects of α1A-adrenoceptor antagonists on the urethral perfusion pressure of the female rat [J].
Bae, JH ;
Jung, PB ;
Lee, JG .
BJU INTERNATIONAL, 2005, 96 (07) :1131-1135
[3]   The component reflexes of micturition in the cat Part III [J].
Barrington, FJF .
BRAIN, 1941, 64 :239-243
[4]   The component reflexes of micturition in the cat. Parts I and II. [J].
Barrington, FJF .
BRAIN, 1931, 54 :177-188
[5]   Frequency-dependent selection of reflexes by pudendal afferents in the cat [J].
Boggs, Joseph W. ;
Wenzel, Brian J. ;
Gustafson, Kenneth J. ;
Grill, Warren M. .
JOURNAL OF PHYSIOLOGY-LONDON, 2006, 577 (01) :115-126
[6]   Neuromodulation and the Neurogenic Bladder [J].
Burks, Frank N. ;
Bui, Don T. ;
Peters, Kenneth M. .
UROLOGIC CLINICS OF NORTH AMERICA, 2010, 37 (04) :559-+
[7]   The management of neurogenic bladder and sexual dysfunction after spinal cord injury [J].
Burns, AS ;
Rivas, DA ;
Ditunno, JF .
SPINE, 2001, 26 (24) :S129-S136
[8]   Miniature intravesical urethral lengthening procedure for treatment of pediatric neurogenic urinary incontinence [J].
Canales, Benjamin K. ;
Fung, Leo C. T. ;
Elliott, Sean P. .
JOURNAL OF UROLOGY, 2006, 176 (06) :2663-2666
[9]   Intravesical capsaicin and resiniferatoxin therapy: Spicing up the ways to treat the overactive bladder [J].
Chancellor, MB ;
de Groat, WC .
JOURNAL OF UROLOGY, 1999, 162 (01) :3-11
[10]   Pudendal neuromodulation improves voiding efficiency in diabetic rats [J].
Chen, Shih-Ching ;
Lai, Chien-Hung ;
Fan, Wen-Jia ;
Peng, Chih-Wei .
NEUROUROLOGY AND URODYNAMICS, 2013, 32 (03) :293-300