Efficacy of a novel wearable transcutaneous tibial nerve stimulation device on bladder reflex compared to implantable tibial nerve stimulation in cats.

Abstract

To determine the efficacy of novel wearable transcutaneous tibial nerve stimulation (TTNS) device on bladder reflex in cats compared to implantable tibial nerve stimulation (ITNS). Two self-adhesive electrodes of the TTNS device were placed at the left leg, and ITNS was applied to stimulate the tibial nerve of the right leg, respectively. The intensity threshold (T) was defined as inducing observable toe movement. Multiple cystometrograms (CMGs) with normal saline (NS) infusion were performed to determine the inhibitory effects of TTNS and ITNS on the micturition reflex. TTNS at 4 times T (4T), 6 times T (6T), and the maximum output current intensity 24mA significantly increased the bladder capacity (BC) compared to the control level (8.70 ± 2.46ml) (all p < 0.05); however, there was no statistical significance among the three intensities. At the same time, ITNS at 2 times T (2T), 4T, 6T, and the current intension 24mA could significantly increase the BC compared to the control level (all p < 0.05). Likewise, no significant difference was observed among the four intensities (p > 0.05). The T values of TTNS were higher than those of ITNS (p = 0.02). The inhibitory effects of TTNS and ITNS revealed no significant difference at their respective 2T, 4T, 6T, and 24mA. Neither TTNS nor ITNS changed the contraction duration and amplitude (all p > 0.05). TTNS was effective in increasing BC. The non-invasive neuromodulation technique could achieve a similar effect as ITNS.