Abstract
ObjectiveWe aimed to refine electroneurogram techniques for monitoring hypogastric nerve activity during bladder filling, and then examined nerve activity in normal intact versus acutely decentralized bladders.MethodsEffects of electrical stimulation of hypogastric nerves or lumbar ventral roots on detrusor pressure were examined, as were effects of isoflurane versus propofol anesthetics on hypogastric nerve stimulation evoked pressure. Hypogastric nerve activity was then recorded using custom-made bipolar cuff electrodes during bladder filling before and after its transection between the spinal cord and electrode to eliminate efferent nerve signals.ResultsElectrical stimulation of hypogastric nerves evoked low amplitude detrusor pressures that did not differ between the two anesthetics. Upper lumbar (L2) ventral root stimulation evoked detrusor pressures were suppressed, yet not eliminated, after transection of hypogastric nerves and all spinal roots below L5. Afferent and efferent hypogastric nerve activity did not change with bladder filling in neuronally intact bladders yet decreased in decentralized bladders. No change in afferent activity was observed during bladder filling in either intact or decentralized bladders.ConclusionsThese findings indicate that a more complete decentralized bladder model should include transection of lumbosacral spinal roots innervating the bladder as well as hypogastric nerves. These refined electroneurogram recording methods may be suitable for evaluating the effectiveness of nerve transfer surgeries for bladder reinnervation by monitoring sensory activity in the transferred nerve.
Highlights
Spinal cord injury (SCI) disturbs normal bladder function, reduces quality of life, and can limit social contacts [1]
In a porcine model, increased afferent activity was recorded from the right pelvic nerve and right Sacral (S) 2 and S3 roots during bladder filling [9]
We examined the effects of bladder filling on hypogastric nerve recordings in 10 animals with intact bladders (Fig 5)
Summary
Spinal cord injury (SCI) disturbs normal bladder function, reduces quality of life, and can limit social contacts [1]. Understanding afferent contributions to normal bladder function is an area of rapidly growing interest for the treatment of lower urinary tract dysfunction [4,5,6]. In rats, increased afferent activity was recorded from postganglionic branches of the pelvic nerve (located between the major pelvic ganglion and the bladder) [8]. In a porcine model, increased afferent activity was recorded from the right pelvic nerve and right Sacral (S) 2 and S3 roots during bladder filling [9]. Activity of the S1 root during slow bladder filling resulted in a small (
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