Bladder emptying by intermittent electrical stimulation of the pudendal nerve

Journal of Neural Engineering
Joseph W BoggsWarren M Grill

Abstract

Persons with a suprasacral spinal cord injury cannot empty their bladder voluntarily. Bladder emptying can be restored by intermittent electrical stimulation of the sacral nerve roots (SR) to cause bladder contraction. However, this therapy requires sensory nerve transection to prevent dyssynergic contraction of the external urethral sphincter (EUS). Stimulation of the compound pudendal nerve trunk (PN) activates spinal micturition circuitry, leading to a reflex bladder contraction without a reflex EUS contraction. The present study determined if PN stimulation could produce bladder emptying without nerve transection in cats anesthetized with alpha-chloralose. With all nerves intact, intermittent PN stimulation emptied the bladder (64 +/- 14% of initial volume, n = 37 across six cats) more effectively than either distention-evoked micturition (40 +/- 19%, p < 0.001, n = 27 across six cats) or bilateral intermittent SR stimulation (25 +/- 23%, p < 0.005, n = 4 across two cats). After bilateral transection of the nerves innervating the urethral sphincter, intermittent SR stimulation voided 79 +/- 17% (n = 12 across three cats), comparable to clinical results obtained with SR stimulation. Voiding via intermittent PN stimulation di...Continue Reading

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Citations

Dec 7, 2007·Journal of Neural Engineering·Victor PikovDouglas B McCreery
Apr 25, 2008·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·John P WoockWarren M Grill
Nov 12, 2010·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·John P WoockWarren M Grill
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Aug 27, 2010·The Journal of Spinal Cord Medicine·Michael J KennellyJoseph W Boggs
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Nov 28, 2014·American Journal of Physiology. Renal Physiology·Mario Kovacevic, Paul B Yoo

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