Noninvasive spinal neuromodulation to map and augment lower urinary tract function in rhesus macaques

Area of Science:

• Neuroscience
• Urology

Background:

• Lower urinary tract (LUT) dysfunction is common in neurological disorders, leading to symptoms like urinary retention.
• Current neuromodulation treatments effectively manage overactive bladder but lack solutions for urinary retention.
• There is a need for interventions that can induce voiding in patients with neurological conditions.

Purpose of the Study:

• To investigate the efficacy of transcutaneous spinal cord stimulation (TSCS) in activating the lower urinary tract (LUT).
• To assess the potential of TSCS as a non-invasive treatment for inducing voiding and overcoming urinary retention.

Main Methods:

• TSCS was applied non-invasively over the thoracolumbar spine in neurologically intact rhesus macaques.
• Urodynamic studies were conducted to evaluate LUT activation, including detrusor muscle and urethral sphincter activity.
• Measurements included voiding efficiency, post-voiding residual volumes, detrusor pressure, contraction duration, and urine flow rate.

Main Results:

• TSCS successfully activated the LUT, engaging the bladder detrusor muscle, urethral sphincter, and pelvic floor muscles.
• Urodynamic studies demonstrated improved voiding efficiency and reduced post-voiding residual volumes.
• Coordinated detrusor and sphincter activity was maintained with unchanged physiologic parameters.

Conclusions:

• TSCS is a novel, non-invasive intervention capable of activating the lower urinary tract (LUT).
• This approach may offer a new therapeutic strategy for enabling voiding in individuals with neurological conditions causing urinary retention.