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Related Experiment Videos

Selective sacral root stimulation for bladder control: acute experiments in an animal model

E L Koldewijn1, N J Rijkhoff, E V van Kerrebroeck

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

The Journal of Urology
|June 1, 1994
PubMed
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Researchers explored selective sacral root stimulation to prevent high bladder pressure during bladder emptying in spinal cord injury patients. This method achieved complete, low-pressure voiding by activating the bladder without the urethral sphincter.

Area of Science:

  • Neuroscience
  • Urology
  • Biomedical Engineering

Background:

  • High bladder pressure is a significant risk during stimulation-induced voiding in spinal cord injury (SCI) patients.
  • Current methods for bladder emptying in SCI can lead to potentially harmful side effects.
  • Preventing detrusor-sphincter dyssynergia is crucial for safe and effective bladder management.

Purpose of the Study:

  • To investigate selective activation of the bladder detrusor muscle without concurrent urethral sphincter activation.
  • To develop a method for achieving low-pressure bladder emptying in a canine model.
  • To mitigate the risk of high bladder pressure associated with poststimulus voiding.

Main Methods:

  • Utilized a canine animal model for acute experiments.

Related Experiment Videos

  • Performed selective stimulation of the sacral root S2 using a tripolar cuff electrode.
  • Employed a custom stimulator to generate adjustable pulse shapes, focusing on pulse width modulation (600-800 microseconds) to achieve selective nerve fiber activation via anodal blocking.
  • Monitored bladder, urethral, and rectal pressures, along with electromyography (EMG) of tail muscles and the urethral sphincter.

    • Main Results:

    • Demonstrated selective activation of the bladder detrusor muscle without simultaneous activation of the external urethral sphincter.
    • Achieved complete bladder emptying at low pressures.
    • Identified specific pulse parameters (600-800 microseconds) that enable selective nerve fiber stimulation through anodal blocking.

    Conclusions:

    • Selective stimulation of sacral roots can achieve detrusor activation while inhibiting urethral sphincter response.
    • This technique offers a promising approach to prevent high bladder pressure during functional electrical stimulation for bladder emptying in SCI.
    • The findings support the potential for improved, safer bladder management strategies in patients with spinal cord injuries.