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Related Experiment Videos

Selective stimulation of sacral nerve roots for bladder control: a study by computer modeling

N J Rijkhoff1, J Holsheimer, E L Koldewijn

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

IEEE Transactions on Bio-Medical Engineering
|May 1, 1994
PubMed
Summary

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This study used computer modeling to find conditions for selective detrusor muscle activation. Results show asymmetrical tripolar stimulation can activate the detrusor without affecting the urethral sphincter or afferent nerves.

Area of Science:

  • Neuroscience
  • Biomedical Engineering
  • Computational Biology

Background:

  • Sacral root stimulation is a potential therapy for bladder dysfunction.
  • Current methods may lack selectivity, causing unwanted side effects like urethral sphincter activation or sensory nerve stimulation.

Purpose of the Study:

  • To theoretically investigate conditions for selective detrusor muscle activation.
  • To identify parameters for activating the detrusor without engaging the urethral sphincter and afferent fibers during sacral root stimulation.

Main Methods:

  • Developed a 3-D computer model of a sacral nerve root with a cuff electrode.
  • Modeled nerve fiber electrical properties and response to tripolar stimulation.
  • Analyzed nerve fiber excitation and blocking thresholds based on geometric and electrical parameters.

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Main Results:

  • Determined optimal geometric and electrical parameters for selective sacral root stimulation.
  • An asymmetrical tripolar cuff design can generate unidirectional action potentials in small nerve fibers.
  • This design can bidirectionally block large nerve fibers.

Conclusions:

  • Selective activation of the detrusor muscle is theoretically possible.
  • Achieving detrusor activation without urethral sphincter or afferent fiber involvement is feasible using optimized tripolar stimulation parameters.