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Detrusor Underactivity Model in Rats by Conus Medullaris Transection
Published on: August 28, 2020
Bladder voiding by combined high frequency electrical pudendal nerve block and sacral root stimulation.
Adam Boger1, Narendra Bhadra, Kenneth J Gustafson
1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio 44106-7207, USA.
Neurourology and Urodynamics
|November 29, 2007
Summary
High-frequency alternating current (HFAC) nerve block of the pudendal nerves (PN) effectively restored bladder voiding in cats with spinal cord injury. This approach may offer a new treatment for bladder dysfunction in humans.
Area of Science:
- Neuroscience
- Urology
- Biomedical Engineering
Background:
- Spinal cord injury often causes detrusor sphincter dyssynergia, leading to impaired bladder voiding.
- Uncoordinated external urethral sphincter contractions prevent bladder emptying in individuals with spinal cord injury.
Purpose of the Study:
- To investigate the efficacy of high-frequency alternating current (HFAC) conduction block of the pudendal nerves (PN) in restoring bladder voiding.
- To determine if HFAC block of the PN can eliminate external urethral sphincter activation and facilitate low residual bladder emptying.
Main Methods:
- Bilateral implantation of tripolar nerve cuff electrodes on the pudendal nerves (PN) and S2 roots in cats.
- Recording of bladder and urethral pressures, volumes, and flow.
- Application of bilateral HFAC stimulation to the PN to achieve conduction block, with sacral root stimulation for bladder activation.
- Comparison of voiding efficiency with and without HFAC PN block, and after PN neurotomy.
Main Results:
- Effective bilateral PN block and voiding were achieved in 3 out of 4 animals.
- HFAC stimulation significantly improved bladder voiding from 2% to 77% of initial bladder volume (P < 0.001).
- HFAC block reduced maximum bladder pressure during voiding and did not differ significantly from post-neurotomy voiding.
Conclusions:
- Bilateral HFAC block of the pudendal nerves effectively produces bladder voiding.
- This neural blockade technique shows promise for developing neural prostheses to aid micturition in individuals with spinal cord injury.
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