Bladder contractions evoked by pudendal nerve stimulation in both spinal intact and spinal transected cats support the possibility of restoring urinary function in persons with chronic spinal cord injury (SCI). However, electrically evoked bladder responses in persons with SCI were limited to transient contractions at relatively low pressures. This prompted the present study, which presents a detailed quantification of the responses evoked by selective stimulation of individual branches of the pudendal nerve at different stimulation frequencies. In spinal intact cats anesthetized with alpha-chloralose, selective frequency-dependent electrical activation of the sensory (2 Hz <= f <= 550 Hz), cranial sensory (f <= 5 Hz), dorsal genital (f <= 20 Hz) and rectal perineal (f <= 10 Hz) branches of the pudendal nerve evoked sustained bladder contractions dependent on the stimulation frequency. Contractions evoked by selective electrical Stimulation resulted in significant increases in voiding efficiency Compared to bladder emptying by distension-evoked contractions (P-ANOVA<0.05). Acute spinal transection abolished reflex bladder contractions evoked by low frequency stimulation of the cranial sensory or rectal perineal branches, whereas contractions evoked by high frequency stimulation of the dorsal genital branch remained intact. This study presents evidence for two distinct micturition pathways (spino-bulbo-spinal vs. spinal reflexes) activated by selective afferent pudendal nerve stimulation, the latter of which may be applied to restore bladder function in persons with SCI. (C) 2008 Elsevier Inc. All rights reserved.
机构:
NW London Hosp NHS Trust, St Marks Hosp, Dept Physiol, Harrow HA1 3UJ, Middx, EnglandNW London Hosp NHS Trust, St Marks Hosp, Dept Physiol, Harrow HA1 3UJ, Middx, England
George, A. T.
Dudding, T. C.
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NW London Hosp NHS Trust, St Marks Hosp, Dept Physiol, Harrow HA1 3UJ, Middx, EnglandNW London Hosp NHS Trust, St Marks Hosp, Dept Physiol, Harrow HA1 3UJ, Middx, England
Dudding, T. C.
Nicholls, R. J.
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NW London Hosp NHS Trust, St Marks Hosp, Dept Colorectal Surg, Harrow HA1 3UJ, Middx, EnglandNW London Hosp NHS Trust, St Marks Hosp, Dept Physiol, Harrow HA1 3UJ, Middx, England
Nicholls, R. J.
Vaizey, C. J.
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NW London Hosp NHS Trust, St Marks Hosp, Dept Physiol, Harrow HA1 3UJ, Middx, EnglandNW London Hosp NHS Trust, St Marks Hosp, Dept Physiol, Harrow HA1 3UJ, Middx, England
机构:
San Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, ItalySan Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, Italy
Terzoni, Stefano
Ferrara, Paolo
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San Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, ItalySan Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, Italy
Ferrara, Paolo
Mora, Cristina
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San Paolo Teaching Hosp, Pelv Floor Outpatients Clin, Milan, ItalySan Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, Italy
Mora, Cristina
Alessandrini, Sara
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IRCCS Ctr Cardiol Monzino, Milan, ItalySan Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, Italy
Alessandrini, Sara
Federica, Arianna
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IRCCS Ctr Cardiol Monzino, Milan, ItalySan Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, Italy
Federica, Arianna
Montanari, Emanuele
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IRCCS Fdn Ca Granda Osped Maggiore Policlin, Dept Urol, Milan, Italy
Univ Milan, Dept Clin Sci & Community Hlth, Milan, ItalySan Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, Italy
Montanari, Emanuele
Destrebecq, Anne
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Univ Milan, Dept Clin Sci & Community Hlth, Milan, ItalySan Paolo Teaching Hosp, San Paolo Bachelor Sch Nursing, Via Ovada 26, I-20142 Milan, Italy