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Proof of concept trial on changes in current perception threshold after sacral neuromodulation
David L Wenzler1, Frank N Burks, Maureen Cooney
1Department of Urology, Beaumont Health System, Royal Oak, MI, USA.
Summary
Sacral neuromodulation (SNM) alters bladder sensitivity by modulating large myelinated nerve fibers. This study shows SNM affects current perception thresholds (CPTs) in the bladder, indicating potential changes in neural pathways.
Area of Science:
- Neuroscience
- Urology
- Biomedical Engineering
Background:
- Sacral neuromodulation (SNM) is a therapeutic approach targeting neural pathways involved in bladder and urethral sensation.
- Altering these neural pathways is theorized to modify sensory perception.
Purpose of the Study:
- To investigate the effect of SNM on current perception thresholds (CPTs) in afferent sensory nerve pathways.
- To determine if SNM modulates C-fibers, Aδ-fibers, and Aβ-fibers in the bladder and urethra.
Main Methods:
- Eight women underwent pre and postoperative CPT testing.
- CPT was measured at 5 Hz (C-fibers), 250 Hz (Aδ-fibers), and 2000 Hz (Aβ-fibers) on the urethra and bladder.
- Index finger readings at 2000 Hz served as control measurements.
Main Results:
- SNM demonstrated the most significant effect on the bladder at 250 Hz and 2000 Hz, suggesting reduced bladder sensitivity.
- A statistically significant decrease in bladder sensitivity (p = 0.033) was observed at 2000 Hz.
- CPT testing was well-tolerated with no reported adverse events.
Conclusions:
- The findings suggest that SNM modulates large myelinated afferent fibers (Aδ and Aβ) in the bladder.
- Minimal changes were observed in C-fiber CPT measurements.
- Further research with larger sample sizes is warranted to confirm the significance of these findings.
