MP08-16 LOW PRESSURE VOIDING INDUCED BY PUDENDAL NERVE STIMULATION AND BLOCK USING LEAD ELECTRODES IN CATS

Abstract

You have accessJournal of UrologyBladder & Urethra: Anatomy, Physiology & Pharmacology (MP08)1 Sep 2021MP08-16 LOW PRESSURE VOIDING INDUCED BY PUDENDAL NERVE STIMULATION AND BLOCK USING LEAD ELECTRODES IN CATS Jialiang Chen, Jianan Jian, Jicheng Wang, Zhijun Shen, Bing Shen, William Wang, Jonathan Beckel, William C de Groat, Christopher Chermansky, and Changfeng Tai Jialiang ChenJialiang Chen More articles by this author , Jianan JianJianan Jian More articles by this author , Jicheng WangJicheng Wang More articles by this author , Zhijun ShenZhijun Shen More articles by this author , Bing ShenBing Shen More articles by this author , William WangWilliam Wang More articles by this author , Jonathan BeckelJonathan Beckel More articles by this author , William C de GroatWilliam C de Groat More articles by this author , Christopher ChermanskyChristopher Chermansky More articles by this author , and Changfeng TaiChangfeng Tai More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001981.16AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We have previously shown that detrusor sphincter dyssynergia (DSD) in spinal cord injured (SCI) cats can be blocked with high frequency, biphasic, bilateral stimulation of the pudendal nerves using cuff electrodes. Also, we showed that combining this block with lower frequency (30 Hz) unilateral pudendal nerve stimulation (PNS) resulted in low-pressure (≤50 cmH2O) voiding in SCI cats. In this experiment, we sought to determine whether wire lead electrodes could be used to block and stimulate the pudendal nerve in spinal intact cats to achieve low-pressure voiding. METHODS: In anesthetized cats, wire lead electrodes were placed on both pudendal nerves. High frequency biphasic stimulation (1 kHz) was applied to block the nerve while 30 Hz stimulus pulses (0.2 ms) applied by a separate lead electrode located proximally on the nerve was used to elicit contractions of the external urethral sphincter (EUS) or induce a reflex bladder contraction. In 4 cats, a catheter was inserted into the distal urethra to perfuse and measure the increase in urethral pressure (IUP) caused by EUS contraction. In another 4 cats, intravesical pressure was measured via a catheter inserted into the bladder dome. RESULTS: The 1 kHz stimulation (30-60 secs, 0.5-5 mA) produced a complete post-stimulation block of PNS evoked IUP for ≥2 mins (see figure 1) and a partial block lasting 6-18 minutes. The block duration lengthened after increasing either the intensity or duration of the kHz stimulation. Without the 1 kHz block, 30 Hz stimulation alone induced high-pressure (90 cmH2O) voiding (see figure 2). When combined with the 1 kHz block, the 30 Hz stimulation induced low-pressure (≤50 cmH2O) voiding with a voiding efficiency of 80%. CONCLUSIONS: This study demonstrated that the pudendal nerve can be successfully blocked by a lead electrode. Furthermore, combining 1 kHz PNS, which blocks EUS contractions, and 30 Hz PNS, which stimulates the bladder, results in low-pressure voiding that is highly efficient. Source of Funding: Bridging the Gap Plus (BG+) program of DARPA under contract N66001-20-C-4050 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e156-e157 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jialiang Chen More articles by this author Jianan Jian More articles by this author Jicheng Wang More articles by this author Zhijun Shen More articles by this author Bing Shen More articles by this author William Wang More articles by this author Jonathan Beckel More articles by this author William C de Groat More articles by this author Christopher Chermansky More articles by this author Changfeng Tai More articles by this author Expand All Advertisement Loading ...