290 THE SKELETAL NEUROMUSCULAR JUNCTION NICOTINIC RECEPTOR ANTAGONIST SUCCINYL CHOLINE BLOCKS BLADDER CONTRACTIONS INDUCED BY FUNCTIONAL ELECTRICAL STIMULATION OF A NEW NEURONAL PATHWAY CREATED BY REINNERVATION WITH GENITOFEMORAL TO PELVIC NERVE TRANSFER

Abstract

You have accessJournal of UrologyBladder and Urethra: Anatomy, Physiology and Pharmacology (I)1 Apr 2013290 THE SKELETAL NEUROMUSCULAR JUNCTION NICOTINIC RECEPTOR ANTAGONIST SUCCINYL CHOLINE BLOCKS BLADDER CONTRACTIONS INDUCED BY FUNCTIONAL ELECTRICAL STIMULATION OF A NEW NEURONAL PATHWAY CREATED BY REINNERVATION WITH GENITOFEMORAL TO PELVIC NERVE TRANSFER Michael Ruggieri, Sandra Gomez, Alan Braverman, Vicky Massicotte, and Mary Barbe Michael RuggieriMichael Ruggieri Philadelphia, PA More articles by this author , Sandra GomezSandra Gomez Philadelphia, PA More articles by this author , Alan BravermanAlan Braverman Philadelphia, PA More articles by this author , Vicky MassicotteVicky Massicotte Philadelphia, PA More articles by this author , and Mary BarbeMary Barbe Philadelphia, PA More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1674AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Following bladder denervation by transection of sacral spinal cord roots, genitofemoral nerve (GFN) transfer to vesical branches of pelvic nerve (PN) reinnervates the canine bladder because functional electrical stimulation of the transferred GFN induces bladder contraction. The new pathway reinnervates both intramural bladder ganglia as well as detrusor smooth muscle cells directly which are not normally innervated by parasympathetic spinal cord neurons. This study investigates whether the reinnervated neuronal pathway mediates contraction by the same neurotransmitter and receptor mechanisms as the original pathway. METHODS After bladder, urethral sphincter and anal sphincter denervation in 4 female canines, GFN were transferred bilaterally to PN and implanted with nerve cuff electrodes interfaced with radiofrequency micro-stimulators (RFMS). The effect of GFN stimulation on bladder pressure was determined before and after neuromuscular blockade with succinyl choline (SC) 3-6 months after reinnervation. The effects of SC on bladder contractions induced by intraoperative electrical stimulation of sacral spinal nerve roots was determined in 1 normal control and by stimulation of vesical branches of the pelvic nerve in 3 sham operated controls. RESULTS RFMS functional electrical stimulation of the GFN induced bladder contractions in 7 of 8 transferred nerves causing pressure increases of 11.2±4.1 cm H2O that were completely blocked with succinyl choline. Stimulation of the sacral nerve roots in the normal control induced bladder, urethral sphincter and anal sphincter pressure. The urethral and anal sphincter pressures were completely blocked with succinyl choline but the bladder pressure increases induced by sacral root stimulation in the normal control or pelvic nerve stimulation in the sham operate controls were not affected (13.5±3.3 vs 11.4±3.1 cm H2O). CONCLUSIONS This study demonstrates plasticity in the nicotinic receptors involved in nerve evoked bladder contractions induced by bladder reinnervation. GF to PN transfer results in the emergence of succinyl choline sensitive nicotinic receptors in this pathway that normally mediate cholinergic contractions at the neuromuscular junction of skeletal but not smooth muscle. These new nicotinic receptors may mediate contractions of the reinnervated bladder at the intramural ganglia cells or the newly reinnervated smooth muscle cells. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e118 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Michael Ruggieri Philadelphia, PA More articles by this author Sandra Gomez Philadelphia, PA More articles by this author Alan Braverman Philadelphia, PA More articles by this author Vicky Massicotte Philadelphia, PA More articles by this author Mary Barbe Philadelphia, PA More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...