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Related Experiment Videos

Urethral sphincteric responses to sacral root stimulation.

P E Van Kerrebroeck1, H Wijkstra, B Bemelmans

  • 1Department of Urology, University Hospital Nijmegen, The Netherlands.

European Urology
|January 1, 1991
PubMed
Summary
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Sacral nerve stimulation in spinal cord injury patients reveals parasympathetic control of the urethra. Low-frequency posterior root stimulation causes urethral relaxation, while high-frequency anterior root stimulation triggers bladder contraction and urethral relaxation.

Area of Science:

  • Neuroscience
  • Urology
  • Spinal Cord Injury Research

Background:

  • Understanding parasympathetic nervous system's role in bladder and urethral function is crucial, especially in patients with complete spinal cord lesions.
  • Sacral nerve deafferentation and stimulation provide a unique model to investigate these neural pathways.
  • The Finetech-Brindley anterior sacral root stimulator implantation offers an opportunity for experimental nerve stimulation.

Purpose of the Study:

  • To investigate the parasympathetic influence on urethral behavior in patients with complete spinal cord lesions.
  • To determine the effects of sacral nerve root stimulation at varying frequencies and voltages on bladder and urethral responses.
  • To explore the presence of an afferent parasympathetic inhibitory mechanism within the human spinal micturition center.

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Main Methods:

  • Intradural sacral deafferentation of posterior roots S2 to S4/S5 was performed in patients undergoing spinal cord stimulator implantation.
  • Sacral roots were stimulated using varying frequencies (3 Hz and 30 Hz) and voltages (3 V and 10 V).
  • Bladder and urethral responses, including pressure changes and contractions/relaxations, were meticulously recorded.

Main Results:

  • Stimulation of posterior sacral roots at 3 Hz resulted in isolated urethral relaxation without concurrent bladder contraction.
  • Anterior sacral root stimulation at 3 Hz showed no significant effect on bladder or urethral pressure.
  • Stimulation of anterior sacral roots at 30 Hz elicited simultaneous bladder contraction and urethral relaxation.

Conclusions:

  • The findings support the existence of an afferent parasympathetic inhibitory pathway influencing the human spinal micturition center.
  • Differential stimulation frequencies of sacral roots can selectively modulate urethral and bladder activity.
  • This research provides insights into the neural control of micturition in the context of spinal cord injury.