Efficient Voiding Research Articles

Voluntary urination control by brainstem neurons that relax the urethral sphincter.

Voluntary urination ensures that waste is eliminated when safe and socially appropriate, even without a pressing urge. Uncontrolled urination, or incontinence, is a common problem with few treatment options. Normal urine release requires a small region in the brainstem known as Barrington’s nucleus (Bar), but specific neurons that relax the urethral sphincter and enable urine flow are unknown. Here we identify a small subset of novel Bar neurons that control the urethral sphincter in mice. These excitatory neurons express estrogen receptor 1 (BarESR1), project to sphincter-relaxing interneurons in the spinal cord and are active during natural urination. Optogenetic stimulation of BarESR1 neurons rapidly initiates sphincter bursting and efficient voiding in anesthetized and behaving animals. Conversely, optogenetic and chemogenetic inhibition reveals their necessity in motivated urination behavior. The identification of these cells provides an expanded model for the control of urination and its dysfunction.

Energy Efficient Routing Algorithm for Void Avoidance in UWSN Using Residual Energy and Depth Variance

Underwater Wireless Sensor Networks (UWSN) is attracting the interest of most of the researcher because of the good opportunity to discover and catch the oceanic activities. As we know radio waves could not work efficiently in Underwater so Underwater Acoustic Sensor Networks (UASN) emerged as a most prevalent network to an outstanding range. UASN have some constraints in its deployment as well as acoustic wave communication. This limitation involves large propagation delay, transmission cost, very less bandwidth, high signal attenuation, and restricted accessibility of the nodes and non-availability of the recharging of nodes leads to the development of some energy saving algorithms to prolong the lifetime of the nodes. Routing technique must be rich enough to overcome all these constraints and give an energy efficient path by avoiding void regions and increase the network lifetime. Depth based algorithms proposed in the last decades use depth factor to estimate the path from sender to the sink. By having the holding time calculation they minimize the replication of information. Here, this paper have proposed Energy Efficient Void Avoidance Routing Scheme for UWSN (E2RV) using Residual Energy and Depth Variance it used two hop node information to escape the void shacks in the network area along with this it is using regularized remaining energy and normalized depth of the nodes to estimate the path from data generating node to sink node. In this way E2RV not only removing the void holes but also maintains the energy depletion of the network nodes and upsurge the network lifetime. Simulation results show the improvement of E2RV over previously defined algorithms in terms of packet delivery ratio, duplications, less energy depletion and increased lifetime.

Permeability Test of Saturated Clay under Stepwise Loading

Issues in the consolidation deformation of saturated clay have a close relationship with its permeability. In this work, a modified K0 oedometer was used to conduct a variable water head permeability test. The changing law of the initial water head H0, effective void ratio, and permeability and effective permeability coefficients were analyzed under various load degrees combined with the concept of efficient void ratio of saturated clay. Our study showed the following results. The initial water head of undisturbed soil could be divided into two stages:rapidly increasing and slowly increasing, the initial water head of disturbed soil was related to the change rate of the total water head. The efficient void ratio of undisturbed soil decreased with an increase in consolidation pressure. The change law of the void ratio of disturbed soil was similar to that of undisturbed soil. In addition, when the soil structure tended to fail, the structural differences tended to be consistent. If the efficient void ratio was large, then the permeability coefficient was also large. The permeability coefficient of clayey soil was related not only to soil structure but also to initial void ratio. Finally, the efficient void ratio and the water head and its change law had a considerable influence on consolidation.

Therapeutic effect of urethral sphincter onabotulinumtoxinA injection for urethral sphincter hyperactivity

Urethral sphincter hyperactivity resulting in voiding dysfunction is frequently encountered. Medical treatment might not achieve a satisfactory result. OnabotlinumtoxinA urethral sphincter injection relaxes sphincter tonicity and possibly resumes efficient voiding. This study analyzed the treatment outcomes and predictor for successful onabotulinumtoxinA treatment on these patients. Patients with voiding dysfunction due to urethral sphincter hyperactivity and treated with injections of 100 U onabotulinumtoxinA into the urethral sphincter were retrospectively reviewed. Treatment outcomes were assessed 1 month after injection using the Global Response Assessment and were analyzed by demographic and baseline video-urodynamic characteristics. Of the 95 patients included, satisfactory outcomes were reported in 58 (61.1%) patients. Treatment outcome was not related to age, gender, or voiding dysfunction subtype. Patients with satisfactory outcomes had a significantly smaller volume at first sensation of filling (P = 0.046), greater detrusor pressure (P = 0.027), higher maximum flow rate (P = 0.017), and smaller post-void residual (P = 0.006). In multivariate analysis, an open bladder neck during voiding was the only predictor for successful outcome (88% in satisfactory outcome, 12% in failure outcome, P < 0.001). Patients with non-neurogenic voiding dysfunction had a significantly longer therapeutic duration than those with neurogenic voiding dysfunction (9.55 ± 4.18 vs 7.44 ± 2.91 months, P = 0.033). Increased urinary incontinence was reported in 18 patients, including 6 with stress urinary incontinence and 12 with urgency urinary incontinence. Subjective improvement was reported in 61.1% of patients with voiding dysfunction due to urethral sphincter hyperactivity after onabotulinumtoxinA urethral sphincter injection. An open bladder neck during voiding at baseline predicts a successful outcome.

Impact of acute intermittent hypoxia (AIH) on lower urinary tract function following mid‐thoracic spinal cord contusion injury

Exposure to acute intermittent hypoxia (AIH) has been reported to improve respiratory and non‐respiratory somatic motor function in rodents and humans, and as such has been proposed as a potential therapeutic intervention for treatment of motor incomplete spinal cord injury (SCI). The benefit of AIH exposure on lower urinary tract (LUT) function following incomplete SCI has begun to be explored by our laboratory albeit the influence of the severity of hypoxia implemented in the AIH protocol remains to be determined. Here, we investigated the potential therapeutic benefit of using 12% O2 as the hypoxic stimulus in an AIH protocol on LUT function following moderate contusion (200 kilodynes) mid‐thoracic (T8 vertebra) SCI (n=12) or sham injuries (spinal cord exposed, no injury; n=5) in adult female Sprague Dawley rats, with results from these studies being compared to our prior work using 10% O2. Four weeks following the SCI/sham, bladder intravesical pressure and external urethral sphincter (EUS) EMG activity were recorded under urethane anesthesia (1.4 g/kg) during continuous infusion of saline (0.04 ml/min) into the bladder to elicit reflex micturition events (spontaneously breathing, vagus nerves intact). Following &gt;60 min of baseline recording, rats were exposed to a single bout of AIH consisting of three five‐minute episodes of hypoxia (12% O2) each separated by five‐minute exposures to room air. Following the AIH exposure, rats continued to spontaneously breathe room air, and data acquisition continued for up to 120 minutes. Prior to AIH, SCI rats exhibited pronounced rhythmic bladder activity consisting of both non‐voiding and voiding contractions. Typically, a series of non‐voiding bladder contractions with increasing amplitude preceded a voiding contraction, and the voiding contractions were incomplete resulting in continuous residual volume and an elevated minimum intravesical pressure. In response to each hypoxic episode, the frequency of voiding contractions increased and was associated with increased output volume and decreased minimum intravesical pressure. During the normoxic period between hypoxic episodes, there was typically a decrease in bladder contractions with increasing minimum intravesical pressure. Immediately following the end of AIH, there was a decrease in rhythmic bladder contractions and output volume that persisted for ~5–10 min, after which a more normal pattern of bladder activity (compared to baseline) emerged, characterized by predominantly a threshold‐driven pattern of bladder contraction with fewer non‐voiding contractions, increased output volume, and decreased minimum intravesical pressure. This post AIH pattern was transient, lasting for only a few cycles. Similar effects on bladder behaviors were noted using 10% O2; however, with 10% O2 the effects were more robust and longer lasting. Sham operated rats exhibited a threshold‐driven pattern of bladder activity with efficient voiding and similar hypoxia‐dependent modulation of contraction frequency and increased output volume following AIH. These data suggest that 12% O2 is effective in modulating LUT function following SCI, but additional optimization strategies are needed to improve the beneficial impact noted.Support or Funding InformationNIH NS096514; NYS DOH SCIRB C32088GGThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Synergistic Activities of Abdominal Muscles Are Required for Efficient Micturition in Anesthetized Female Mice.

PurposeTo characterize the electromyographic activity of abdominal striated muscles during micturition in urethane-anesthetized female mice, and to quantitatively evaluate the contribution of abdominal responses to efficient voiding.MethodsCystometric and multichannel electromyographic recordings were integrated to enable a comprehensive evaluation during micturition in urethane-anesthetized female mice. Four major abdominal muscle domains were evaluated: the external oblique, internal oblique, and superior and inferior rectus abdominis. To further characterize the functionality of the abdominal muscles, pancuronium bromide (25 μg/mL or 50 μg/mL, abdominal surface) was applied as a blocking agent of neuromuscular junctions.ResultsWe observed a robust activation of the abdominal muscles during voiding, with a consistent onset/offset concomitant with the bladder pressure threshold. Pancuronium was effective, in a dose-dependent fashion, for partial and complete blockage of abdominal activity. Electromyographic discharges during voiding were significantly inhibited by applying pancuronium. Decreased cystometric parameters were recorded, including the peak pressure, pressure threshold, intercontractile interval, and voiding duration, suggesting that the voiding efficiency was significantly compromised by abdominal muscle relaxation.ConclusionsThe relevance of the abdominal striated musculature for micturition has remained a topic of debate in human physiology. Although the study was performed on anesthetized mice, these results support the existence of synergistic abdominal electromyographic activity facilitating voiding in anesthetized mice. Further, our study presents a rodent model that can be used for future investigations into micturition-related abdominal activity.

NK2 and NK1 receptor-mediated effects of NKA and analogs on colon, bladder, and arterial pressure in anesthetized dogs.

Tachykinin NK2 receptor (NK2R) agonists have potential to alleviate clinical conditions associated with bladder and gastrointestinal under activity. The effects of agonists with differing selectivity for NK2R over NK1Rs on colorectal, bladder, and cardiovascular function were examined in anesthetized dogs. Intravenous (IV) administration of NKA, LMN-NKA ([Lys5,MeLeu9,Nle10]-NKA(4-10)), and [β-Ala8]-NKA(4-10) caused a dose-related increase in colorectal pressure (up to 98mmHg) that was blocked by pretreatment with the NK2R antagonist GR 159897 (1mg/kg), and hypotension (decrease in mean arterial pressure of ~40mmHg) that was blocked by the NK1R antagonist CP-99,994 (1mg/kg). Despite the greater in vitro selectivity of LMN-NKA and [β-Ala8]-NKA(4-10) for NK2R over NK1Rs compared with NKA, all 3 agonists increased colorectal pressure and caused hypotension within a similar dose range when administered as a bolus (0.1-300μg/kg IV), or even as a slow IV infusion over 5min (NKA; 0.02-0.6μg/kg/min). In contrast, subcutaneous (SC) administration of LMN-NKA (3-10μg/kg) increased colorectal pressure (up to 50mmHg) and elicited micturition (≧ 85% voiding efficiency) without causing hypotension. NK2R agonists can produce rapid-onset, short-duration, colorectal contractions, and efficient voiding of urine without hypotension after SC administration, indicating that routes of administration that avoid the high plasma concentrations associated with IV dosing improve the separation between desired and unwanted pharmacodynamic effects. The potent hypotensive effect of NKA in dogs was unexpected based on published studies in humans in which IV infusion of NKA did not affect blood pressure at doses that increased gastrointestinal motility.

Sensory feedback from the urethra evokes state-dependent lower urinary tract reflexes in rat.

The lower urinary tract is regulated by reflexes responsible for maintaining continence and producing efficient voiding. It is unclear how sensory information from the bladder and urethra engages differential, state-dependent reflexes to either maintain continence or promote voiding. Using a new in vivo experimental approach, we quantified how sensory information from the bladder and urethra are integrated to switch reflex responses to urethral sensory feedback from maintaining continence to producing voiding. The results demonstrate how sensory information regulates state-dependent reflexes in the lower urinary tract and contribute to our understanding of the pathophysiology of urinary retention and incontinence where sensory feedback may engage these reflexes inappropriately. Lower urinary tract reflexes are mediated by peripheral afferents from the bladder (primarily in the pelvic nerve) and the urethra (in the pudendal and pelvic nerves) to maintain continence or initiate micturition. If fluid enters the urethra at low bladder volumes, reflexes relax the bladder and evoke external urethral sphincter (EUS) contraction (guarding reflex) to maintain continence. Conversely, urethral flow at high bladder volumes, excites the bladder (micturition reflex) and relaxes the EUS (augmenting reflex). We conducted measurements in a urethane-anaesthetized in vivo rat preparation to characterize systematically the reflexes evoked by fluid flow through the urethra. We used a novel preparation to manipulate sensory feedback from the bladder and urethra independently by controlling bladder volume and urethral flow. We found a distinct bladder volume threshold (74% of bladder capacity) above which flow-evoked bladder contractions were 252% larger and evoked phasic EUS activation 2.6times as often as responses below threshold, clearly demonstrating a discrete transition between continence (guarding) and micturition (augmenting) reflexes. Below this threshold urethral flow evoked tonic EUS activity, indicative of the guarding reflex, that was proportional to the urethral flow rate. These results demonstrate the complementary roles of sensory feedback from the bladder and urethra in regulating reflexes in the lower urinary tract that depend on the state of the bladder. Understanding the neural control of functional reflexes and how they are mediated by sensory information in the bladder and urethra will open new opportunities, especially in neuromodulation, to treat pathologies of the lower urinary tract.

Synthesis of Robust Silicon Nanoparticles@Void@Graphitic Carbon Spheres for High‐Performance Lithium‐Ion‐Battery Anodes

AbstractSilicon is known to be a promising candidate anode material for lithium‐ion batteries because of its ultrahigh capacity; however, its volume expansion/shrinkage during lithiation/delithiation reactions represent the biggest challenge in practical applications. In this paper, we successfully design and synthesize a new type of robust silicon nanoparticles@void@graphitic carbon spheres (Si@void@C) material to buffer the silicon volume changes in the cyclic lithiation/delithiation process. The as‐obtained Si@void@C nanocomposite spheres with well‐dispersed silicon nanoparticles, efficient void spaces, and graphitic carbon shells can endow this nanocomposite anode with the robustness to solve the volume expansion/shrinkage issue. As demonstrated by coin battery performances, the Si@void@C nanocomposite sphere‐based anode exhibits a specific capacity retention of 1565 and 1260 mAhg−1 at C/5 and C/2 (1C=4200 mAg−1), respectively, after 1000 cycles of deep charge/discharge processes (voltage between 0.01 and 2.7 V versus Li/Li+). It provides a promising anode for a safe and high‐performance Si‐based materials in high‐performance lithium‐ion batteries.

Improvement in Lower Urinary Tract Function Following a Single Bout of Acute Intermittent Hypoxia in Rats with Chronic Spinal Cord Injury

Exposure to acute intermittent hypoxia (AIH) has been reported to improve respiratory and non‐respiratory somatic motor function in rodents and humans and has been proposed as a potential therapeutic intervention for treatment of chronic motor incomplete spinal cord injury (SCI). The goal of the present study is to characterize potential beneficial effects of AIH to improve lower urinary tract (LUT) function following incomplete SCI. To this end, female Sprague Dawley rats (225–250 g; n=11) received moderate midthoracic (T7–T9) spinal cord contusion injuries (200 kilodynes, Infinite Horizon Impactor; n=7) or sham injuries (spinal cord exposed, no injury; n=4) under isoflurane anesthesia. Following SCI, rats were inspected daily for SCI‐related issues (e.g., bladder/urinary tract infections, autophagia, overgrooming), and bladders were manually expressed until spontaneous voiding capability returned. Four weeks following the SCI/sham, bladder intravesical pressure and external urethral sphincter (EUS) EMG activity were recorded under urethane anesthesia (1.4 g/kg) during continuous infusion of saline (0.04 ml/min) into the bladder to elicit reflex micturition events (spontaneously breathing, vagus nerves intact). In addition, EMG data were acquired from the diaphragm and genioglossus muscles to assess effects on inspiratory motor outputs. Following 30–40 minutes of baseline recording, rats were exposed to a single bout of AIH consisting of three five‐minute episodes of hypoxia (10% O2; 90% N2) each separated by five‐minute exposures to room air. Following the AIH exposure, rats continued to spontaneously breathe room air, and data acquisition continued for up to 120 minutes. Prior to AIH, SCI rats exhibited pronounced rhythmic bladder activity consisting of both non‐voiding and voiding contractions. Typically, a series of non‐voiding bladder contractions with increasing amplitude preceded a voiding contraction, and the voiding contractions were incomplete resulting in continuous residual volume and an elevated minimum intravesical pressure. During each hypoxic episode during the AIH, the frequency of rhythmic bladder contraction increased and was associated with increased output volume and decreasing minimum intravesical pressure. In contrast, there was a marked decrease in rhythmic bladder activity during the normoxic period between hypoxic episodes with decreased output volume and increased minimum intravesical pressure. Immediately following the end of AIH, a similar decrease in rhythmic bladder contractions and output volume was observed and persisted for 5–10 minutes after which a more normal pattern of bladder activity (compared to baseline) emerged characterized by fewer non‐voiding contractions, increased output volume per volume per contraction, decreased minimum intravesical pressure, and a threshold‐driven pattern of bladder contraction that persisted up to 120 minutes post AIH. Sham operated rats exhibited a threshold‐driven pattern of bladder activity with efficient voiding and similar hypoxia‐dependent modulation of contraction frequency and increased output volume following AIH. These data suggest that AIH‐induced neuroplasticity results in improved LUT function in rats with chronic incomplete SCI and is a potentially promising therapeutic intervention for humans with SCI.Support or Funding InformationSupport for this project was provided by The Thomas Hartman Center for Parkinson's Research at Stony Brook University and The SUNY Brain Network of Excellence.

MP82-06 DETRUSOR UNDERACTIVITY IN AN OBESE-PRONE RAT MODEL

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research & Pathophysiology II1 Apr 2017MP82-06 DETRUSOR UNDERACTIVITY IN AN OBESE-PRONE RAT MODEL Eric Gonzalez and Warren Grill Eric GonzalezEric Gonzalez More articles by this author and Warren GrillWarren Grill More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.2553AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Detrusor underactivity (DUA) is an understudied health concern that affects up to 45% of men and women in secondary care. The clinical management of DUA is inadequate and fails to improve the quality of life of these patients. The limited availability of animal models that exhibit the integrated pathophysiology of DUA impedes the development of new therapeutic approaches. The current studies characterized the bladder function of an obesity model of DUA to increase our understanding of the initiation and progression of urinary retention. METHODS Animals: Eight-week old female obese-prone (OP) and obese-resistant (OR) rats purchased from Charles River (Boston, MA) were housed two per cage and maintained in standard laboratory conditions with food and water available ad libitum. Experimental procedures were approved by the Duke University IACUC and experimentation was conducted in accordance with the NIH Guide for the Care and Use of Laboratory Animals (8th ed.). High-fat feeding and glucose measurements: OP and OR rats were fed a 45% fat diet (D12451, Research Diets, Inc.) from 9-21 weeks and a 60% fat diet (D12492, Research Diets, Inc.) from 21-24 weeks. Whole blood was collected from the tail vein for glucose analysis at 8 and 24 weeks. Surgical preparation and instrumentation: At 24 weeks, OP and OR rats were anesthetized with urethane (1.2 g/kg s.c. and supplemented as needed). The bladder was exposed through a midline abdominal incision and a flared PE-60 catheter was inserted into the bladder dome. The catheter was secured and connected via a 3-way stopcock to a pressure transducer and infusion pump. A paddle with platinum iridium contacts was placed between the pubic symphysis and the EUS to record EMG signals. Pressure and EMG signals were amplified, filtered, and sampled on a PowerLab acquisition unit with LabChart 7 Pro. RESULTS OP rats weighed significantly more than OR rats (450 ± 11.1 vs. 270 ± 6.7 g, respectively; p ≤ 0.001); however, blood glucose was not altered between OP (169.1 ± 7.11 mg/dl) or OR (176.5 ± 6.09 mg/dl; p ≥ 0.05) rats. Compared to OR rats, OP rats have significantly increased volume threshold (0.7574 ± 0.07 vs. 0.529 ± 0.04 ml; p ≤ 0.05), decreased maximum micturition pressure (16.62 ± 1.2 vs. 23.94 ± 1.1 cmH2O; p ≤ 0.001), and decreased voiding efficiency (8.743 ± 2.58 vs. 42.19 ± 6.5 %; p ≤ 0.001). CONCLUSIONS OP rats exhibit DUA and decreased voiding efficiency. This animal model may be used to understand the pathophysiology underlying DUA and enable the development of novel therapeutic approaches to recover efficient voiding. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e1099 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Eric Gonzalez More articles by this author Warren Grill More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Phasic activation of the external urethral sphincter increases voiding efficiency in the rat and the cat

ObjectiveElectrical stimulation of the pudendal nerve (PN) is a potential therapy for bladder dysfunction, but voiding efficiency (VE) produced by PN stimulation appears limited to 60–70%. We conducted experiments in rats and cats to investigate the hypothesis that introduction of artificial phasic bursting activity of the external urethral sphincter (EUS) would enhance VE under conditions where such activity was absent. Materials and methodsCystometry experiments were conducted in 17 urethane anesthetized female Sprague-Dawley rats and 4 α-chloralose anesthetized male cats. The effects of phasic stimulation of the pudendal motor branch on VE were quantified in intact conditions, following bilateral transection of the motor branch of the PN, and following subsequent bilateral transection of the sensory branch of the PN. ResultsArtificial phasic bursting activity in the EUS generated by electrical stimulation of the motor branch of the PN increased VE in both rats and cats. Subsequent transection of the sensory branch of the PN abolished the increased VE elicited by phasic stimulation in both rats and cats. ConclusionsArtificial phasic EUS bursting restored efficient voiding in rats. Introduction of artificial phasic bursting in cats, which normally exhibit EUS relaxation while voiding, was also effective in promoting efficient voiding. In both species phasic EUS activity increased voiding efficiency via activation of pudendal sensory pathways. These results provide further insight into the function of phasic EUS activity in efficient voiding and highlight a novel approach to increase VE generated by pudendal afferent nerve stimulation.

Peripheral Nerve Transplantation Combined with Acidic Fibroblast Growth Factor and Chondroitinase Induces Regeneration and Improves Urinary Function in Complete Spinal Cord Transected Adult Mice.

The loss of lower urinary tract (LUT) control is a ubiquitous consequence of a complete spinal cord injury, attributed to a lack of regeneration of supraspinal pathways controlling the bladder. Previous work in our lab has utilized a combinatorial therapy of peripheral nerve autografts (PNG), acidic fibroblast growth factor (aFGF), and chondroitinase ABC (ChABC) to treat a complete T8 spinal cord transection in the adult rat, resulting in supraspinal control of bladder function. In the present study we extended these findings by examining the use of the combinatorial PNG+aFGF+ChABC treatment in a T8 transected mouse model, which more closely models human urinary deficits following spinal cord injury. Cystometry analysis and external urethral sphincter electromyograms reveal that treatment with PNG+aFGF+ChABC reduced bladder weight, improved bladder and external urethral sphincter histology, and significantly enhanced LUT function, resulting in more efficient voiding. Treated mice’s injured spinal cord also showed a reduction in collagen scaring, and regeneration of serotonergic and tyrosine hydroxylase-positive axons across the lesion and into the distal spinal cord. Regeneration of serotonin axons correlated with LUT recovery. These results suggest that our mouse model of LUT dysfunction recapitulates the results found in the rat model and may be used to further investigate genetic contributions to regeneration failure.

Regulatory Effects of 5-Hydroxytryptamine Receptors on Voiding Function.

A growing body of evidence suggests that 5-hydroxytryptamine (5-HT; serotonin) has both physiological and pathological functions in the lower urinary tract. A wide variety of 5-HT receptor subtypes are variably expressed in different organs, both peripheral and central. On urinary bladder smooth muscle, 5-HT1A, 5-HT2, 5-HT3, and 5-HT7 subtypes could function as postjunctional receptors. Postjunctional 5-HT2 receptors induce detrusor contraction of the bladder body. 5-HT1A is suggested to have a similar effect to 5-HT2, while 5-HT3 might suppress detrusor contraction evoked by direct muscle stimulation. Postjunctional 5-HT7 is reported to induce relaxation of the bladder neck, which might be required for efficient voiding. 5-HT1A, 5-HT2A, 5-HT2C, 5-HT3, 5-HT4, and 5-HT7 subtypes also could act as prejunctional receptors in autonomic excitatory nerve terminals. 5-HT2A, 5-HT2C, 5-HT3, 5-HT4, and 5-HT7 subtypes facilitate the neurogenic contraction of the detrusor by enhancing cholinergic or purinergic transmission, whereas 5-HT1A receptors might inhibit the release of acetylcholine in the detrusor. Furthermore, 5-HT1D could be involved in the suppression of ATP release from the urothelium, aiding visceral sensation of the urinary bladder. In the central pathways controlling the micturition reflex, 5-HT1A, 5-HT2A, and 5-HT7 are involved in regulation of bladder and urethral sphincter activities. Their functions, especially that of 5-HT1A, vary in a species- and site (spinal or supraspinal)- dependent manner. In addition to urinary bladder, 5-HT could be involved in prostate contraction and cell proliferation. Evidence indicates that 5-HT receptor subtypes may be novel therapeutic targets for lower urinary tract symptoms. Grants-in-Aid for Scientific Research (C) (KAKENHI 23590707, 24590722, and 26460694) from the Japan Society for the Promotion of Science.

Convex-based void filling method for CAD-based Monte Carlo geometry modeling

CAD based automatic geometry modeling tools have been widely applied to generate Monte Carlo (MC) calculation geometry for complex systems according to CAD models. Automatic void filling is one of the main functions in the CAD based MC geometry modeling tools, because the void space between parts in CAD models is traditionally not modeled while MC codes such as MCNP need all the problem space to be described. A dedicated void filling method, named Convex-based Void Filling (CVF), is proposed in this study for efficient void filling and concise void descriptions. The method subdivides all the problem space into disjointed regions using Quality based Subdivision (QS) and describes the void space in each region with complementary descriptions of the convex volumes intersecting with that region. It has been implemented in SuperMC/MCAM, the Multiple-Physics Coupling Analysis Modeling Program, and tested on International Thermonuclear Experimental Reactor (ITER) Alite model. The results showed that the new method reduced both automatic modeling time and MC calculation time.

Sacral neuromodulation outcomes in male patients with chronic urinary retention.

To assess the outcome of two-stage sacral neuromodulation (SNM) in men with chronic urinary retention (CUR) and factors affecting the response. Data were collected from 21 male patients with complete or partial CUR who underwent two-stage SNM between 2006 and 2014. The implanted lead was connected to a temporary battery (stage-1) and they were assessed over a period of 3-12 weeks. Those who had a residual volume of ≤100 mL, had an implantable pulse generator sited (stage-2). Patients were followed up at 3 and 6 months initially, and 12 monthly thereafter. The following parameters were analyzed: age, onset of symptoms, precipitant causes for CUR, type of retention, associated voiding dysfunction and opiate intake. Surgery was the main precipitating cause of CUR in 5 (24%) patients. Stage-1 SNM restored complete efficient voiding in 14 patients (66.7%) out of the 21 patients. The only parameter studied that showed a positive correlation with a successful outcome to SNM was the age of the patient, with a higher success rate in younger males (median age 37 years [p = 0.025]). There was no other significant finding when looking at other parameters studied. Stage-2 was carried out in 13 out of 14 successful stage-1 patients. SNM restored complete voiding or improved bladder emptying in all patients implanted with a battery, and this was sustained until the battery needed to be replaced with a mean follow up of 34 ± 23.7 months except in two cases that had removal after traumatic accidents. Stage-1 SNM was successful in 66.7% of male patients with CUR. Once stage-2 was performed, successful voiding was maintained until the battery needed to be replaced. SNM success was better in men under a median age of 43 years. Further studies are encouraged to study this group of patients.

Efficacy of Holmium Laser Enucleation of the Prostate in Patients With Non-neurogenic Impaired Bladder Contractility: Results of a Prospective Trial

To examine the outcomes of men with detrusor underactivity or acontractility undergoing holmium laser enucleation of the prostate (HoLEP). A prospective case series between 2009 and 2012 was performed to examine short-term outcomes of men with urodynamic evidence of detrusor hypocontractility or acontractility because of a non-neurogenic etiology and concurrent benign prostatic obstruction (BPO), undergoing HoLEP. Fourteen patients with detrusor hypocontractility and 19 patients with acontractility and evidence of BPO underwent HoLEP during the study period. Median age was 71.5 and 75 years, respectively. Preoperatively, 5 (35.7%) men with hypocontractility and 19 (100%) men with acontractility had catheter-dependent urinary retention for a median of 3 and 9 months, respectively. At a median follow-up of 24.7 months, all 5 (100%) men with hypocontractility and 18 of 19 (94.7%) men with acontractility were voiding spontaneously without the need for intermittent catheterization. Individuals with hypocontratile bladders had statistically significant improvements in American Urological Association Symptom Index (21.5 vs 3; P = .014), maximum urine flow (Qmax, 10 vs 21 mL/s; P = .001), and postvoid residual (250 vs 53 mL; P = .007) from baseline to postoperative assessments. In patients with an acontractile bladder, 15 of 19 (78.9%) displayed significant return of detrusor contractility, whereas 4 of 19 (21.1%) were voiding exclusively by Valsalva effort on follow-up urodynamic study. Postoperatively, patient satisfaction, as ascertained by American Urological Association Symptom Index, was high for both groups. Intermediate follow-up results indicate that HoLEP is a viable management option for men with BPO and detrusor hypocontractility. Furthermore, detrusor acontractility does not appear to adversely affect postoperative results, with return of spontaneous urination and demonstration of detrusor contractility allowing for efficient voiding, in over 95% of patients.

Void Avoidance in Underwater Acoustic Sensor Network Using Secure Opportunistic Energy Efficient Depth Routing Protocol

For starters, in UASN, distance between nodes as they move with water current, improved network's energy usage. The second problem with UASNs is void hole occurrence, which affects network performance. Nodes are unable to deliver data to the destination because there are no forwarder nodes (FNs) in the network. As a result, routing in UASNs aims to solve the previously mentioned issues in order to increase the network's lifespan. This research proposed novel technique in Void avoidance in underwater acoustic sensor network (UASN) with improving the energy efficiency of the network and analysing depth with security. In this proposed model, secure opportunistic energy efficient void avoidance protocol (Se_Opp_EE_VA) is used and the depth of the network has been analysed. By avoiding the vacuum zone and balancing network energy with depth analysis and security, the suggested effort extends the network lifetime. Routing techniques must be comprehensive enough to overcome all of these constraints as well as provide an energy-efficient routing that avoids empty zones while also extending network lifetime. The depth factor is used in depth-based algorithms proposed in recent decades to assess the path from sender to sink. They reduce information replication by using the holding time calculation. 81% of QoS, 92% of PDR, 96% of energy efficiency, Network lifetime attained by Proposed Se_Opp_EE_VA is 94%, and 50% of end to end delay have all improved as a result of the simulation.

Effects of urethane on reflex activity of lower urinary tract in decerebrate unanesthetized rats

Effects of urethane on lower urinary tract function were examined in decerebrate unanesthetized rats. During single slow infusion (0.04 ml/min) cystometrograms (CMGs), urethane (0.3 g/kg) increased micturition pressure threshold (PT) by 73%, postvoid residual volume (RV) by 425%, and decreased voiding efficiency (VE) by 57%, but did not change maximal voiding pressure (MVP), closing peak pressure (CPP), bladder compliance, bladder contraction duration (BCD), or volume threshold (VT) for inducing micturition. Lower doses (0.01-0.1 g/kg) did not alter any parameter. During continuous fast infusion (0.21 ml/min) CMGs, urethane at doses of 0.6-1.2 g/kg (iv) markedly decreased CPP by 69-85%, whereas only the largest dose (1.2 g/kg iv) decreased MVP and external urethral sphincter electromyogram activity by 42 and by 80%, respectively. Doses of 0.001-0.6 g/kg did not alter the intercontraction interval and BCD. Taken together, these results suggest that urethral activity, which is essential for efficient voiding, is more sensitive to the suppressive effect of urethane than afferent or efferent mechanisms controlling the bladder. The threshold dose of MK-801 (0.3 mg/kg), an NMDA antagonist, required to decrease MVP and increase VT in urethane (1.2 g/kg)-anesthetized rats, only increased VT in rats treated with a subanesthetic dose of urethane (0.3 g/kg), suggesting a higher sensitivity of the afferent vs. efferent limb of the micturition reflex pathway to urethane-MK-801 interactions. Because effects of urethane persisted after removal of the forebrain, they must be mediated by actions on the brain stem, spinal cord, or peripheral nervous system.

741 Degarelix reduces urodynamic changes in a rat model for experimental detrusor overactivity and causes more efficient voiding

741 Degarelix reduces urodynamic changes in a rat model for experimental detrusor overactivity and causes more efficient voiding