Minimally Invasive Two-passage Electrical Genital Nerve Stimulation: A Human Cadaver Study of a New Technique

Abstract

To present and evaluate the feasibility of a new technique of lead-electrode stimulation to the genital nerves using a 2-step, double-passage retropubic/retrograde approach. Prospective observational study. The procedure was initiated in the retropubic passage by placing the electrode from below through a paravulvar/testicular small incision toward the urogenital diaphragm, guided through the retropubic space along the backside of the pubic bone. Through a second passage along the frontside of the pubic bone, the lead-electrode was placed finally at the genital nerves. Department of Anatomy, University Bern, Bern, Switzerland PARTICIPANTS: The study was performed in 5 cadavers (bilaterally) and tested by 10 obstetrics and gynecology surgeons. Positions and courses of the lead electrode in relation to the dorsal nerve of the clitoris/penis were evaluated by dissection of the genitals and showed an optimal parallel course of the lead electrodes to the dorsal nerve from the perforation of the urogenital diaphragm to the crura of the clitoris, with area of the dorsal nerve of the clitoris/penis to the electrode never exceeding 2 mm. Participant surgeons self-evaluated reproducibility and difficulty of the procedure by using a score from 1 to 10 (1, easy/safe; 10, extremely difficult/dangerous). Both reproducibility and difficulty achieved a score of 1 by all participants. The double-passage genital nerve stimulation procedure is a new peripheral nerve stimulation technique that had a high self-evaluated rate of ease and reproducibility for surgeon participants.