008 Investigating Peripheral Nerve Stimulation as a Treatment for Female Sexual Dysfunction using a Preclinical Model

Abstract

In clinical studies involving sacral neuromodulation (SNM) and percutaneous tibial nerve stimulation (PTNS) for bladder dysfunction and pelvic pain, female patients sometimes note an additional positive impact on sexual function. Few studies have examined this effect preclinically, and there is no standard method for evaluation of genital arousal. Our goals are to investigate the underlying mechanisms of nerve stimulation elicited changes in genital sexual function and to assess behavioral impacts with a preclinical model. In anesthetized female rats, we isolated and stimulated the pudendal nerve (distal branch of SNM target nerve) or tibial nerve unilaterally for thirty minutes with a cuff electrode. Vaginal blood perfusion was measured with laser Doppler flowmetry. Changes in the neurogenic frequency range (NGF; 0.076-0.200 Hz) of the vaginal wall were assessed with wavelet analysis. This frequency analysis focuses on autonomic nervous system-driven effects while rejecting artifacts due to other physiological processes. We identified large increases in the NGF energy (threshold = 500% increase from baseline) as a proxy for genital sexual arousal. Behavioral studies to determine the impact of peripheral stimulation have begun.