Electrical Stimulation Of Pelvic Nerve Research Articles

MP08-10 LATERALIZATION OF BLADDER FUNCTION IN NORMAL FEMALE CANINES

You have accessJournal of UrologyBladder & Urethra: Anatomy, Physiology & Pharmacology (MP08)1 Sep 2021MP08-10 LATERALIZATION OF BLADDER FUNCTION IN NORMAL FEMALE CANINES Dania Giaddui, Mary F. Barbe, Ekta Tiwari, Alan S. Braverman, Danielle S. Porreca, Sandra Gomez-Amaya, Nagat Frara, Lucas J. Hobson, Justin M. Brown, Michael A. Pontari, and Michael R. Ruggieri Dania GiadduiDania Giaddui More articles by this author , Mary F. BarbeMary F. Barbe More articles by this author , Ekta TiwariEkta Tiwari More articles by this author , Alan S. BravermanAlan S. Braverman More articles by this author , Danielle S. PorrecaDanielle S. Porreca More articles by this author , Sandra Gomez-AmayaSandra Gomez-Amaya More articles by this author , Nagat FraraNagat Frara More articles by this author , Lucas J. HobsonLucas J. Hobson More articles by this author , Justin M. BrownJustin M. Brown More articles by this author , Michael A. PontariMichael A. Pontari More articles by this author , and Michael R. RuggieriMichael R. Ruggieri More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000001981.10AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Many organs in the body have either left or right dominance in their innervation. Since the bladder receives innervation from the right and left sides through the spinal cord and the pelvic plexus, this study aimed to examine if stimulations of either the spinal roots or pelvic nerve cause a greater bladder contraction on the left versus the right side. METHODS: Forty-four female canines were included in this study. Functional electrical stimulation (3-5 second trains at 20Hz, 0.02 msec, 0.5-10 mA) of bilateral lumbar (L)6 through sacral (S)3 spinal cord roots and the left and right pelvic plexuses were performed for all animals. Changes in detrusor pressure were continuously recorded during stimulations. Strength of nerve-evoked bladder contractions after spinal root and pelvic plexus stimulations were derived from differences between the resting baseline pressure and the peak pressure obtained during the stimulation. The dominant side for each spinal root and pelvic nerve in each animal was determined by calculating the percent difference (25%) between the left and right stimulation. Bladders are considered left or right sided if differences are greater or less than 25%, respectively. If differences are within 25%, bladders are considered bilaterally innervated. RESULTS: The functional bilateral spinal root stimulation in 2/3 of the 44 dogs examined indicated that the maximum detrusor pressure was shown to be associated with either the left or right side of the spinal cord that was stimulated. Bladders were left side dominant in seventeen dogs (38.6%), right side dominant in 12 dogs (27.2%) and bilateral in 15 dogs (34%). Functional electrical stimulation of pelvic nerve revealed that about 3/4 of the 19 dogs tested, changes in detrusor pressure was shown to be associated with the side that was stimulated. Bladders were left side dominant in 8 dogs (42.1%), right side dominant in 6 dogs (31.6%) and bilateral in the remaining 5 dogs (26.3%). CONCLUSIONS: Overall, these data provide evidence for asymmetry of the bladder function in the normal female dogs. Although, the current observations were obtained from normal animals, the determined left and right dominance of the bladder function might provide the basis for understanding the consequences of lateralization of bladder innervation in patients with bladder dysfunctions. Source of Funding: NINDS R01NS070267 © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e153-e154 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Dania Giaddui More articles by this author Mary F. Barbe More articles by this author Ekta Tiwari More articles by this author Alan S. Braverman More articles by this author Danielle S. Porreca More articles by this author Sandra Gomez-Amaya More articles by this author Nagat Frara More articles by this author Lucas J. Hobson More articles by this author Justin M. Brown More articles by this author Michael A. Pontari More articles by this author Michael R. Ruggieri More articles by this author Expand All Advertisement Loading ...

Novel Neurostimulation of Autonomic Pelvic Nerves Overcomes Bladder-Sphincter Dyssynergia.

The disruption of coordination between smooth muscle contraction in the bladder and the relaxation of the external urethral sphincter (EUS) striated muscle is a common issue in dysfunctional bladders. It is a significant challenge to overcome for neuromodulation approaches to restore bladder control. Bladder-sphincter dyssynergia leads to undesirably high bladder pressures, and poor voiding outcomes, which can pose life-threatening secondary complications. Mixed pelvic nerves are potential peripheral targets for stimulation to treat dysfunctional bladders, but typical electrical stimulation of pelvic nerves activates both the parasympathetic efferent pathway to excite the bladder, as well as the sensory afferent pathway that causes unwanted sphincter contractions. Thus, a novel pelvic nerve stimulation paradigm is required. In anesthetized female rats, we combined a low frequency (10 Hz) stimulation to evoke bladder contraction, and a more proximal 20 kHz stimulation of the pelvic nerve to block afferent activation, in order to produce micturition with reduced bladder-sphincter dyssynergia. Increasing the phase width of low frequency stimulation from 150 to 300 μs alone was able to improve voiding outcome significantly. However, low frequency stimulation of pelvic nerves alone evoked short latency (19.9–20.5 ms) dyssynergic EUS responses, which were abolished with a non-reversible proximal central pelvic nerve cut. We demonstrated that a proximal 20 kHz stimulation of pelvic nerves generated brief onset effects at lower current amplitudes, and was able to either partially or fully block the short latency EUS responses depending on the ratio of the blocking to stimulation current. Our results indicate that ratios >10 increased the efficacy of blocking EUS contractions. Importantly, we also demonstrated for the first time that this combined low and high frequency stimulation approach produced graded control of the bladder, while reversibly blocking afferent signals that elicited dyssynergic EUS contractions, thus improving voiding by 40.5 ± 12.3%. Our findings support advancing pelvic nerves as a suitable neuromodulation target for treating bladder dysfunction, and demonstrate the feasibility of an alternative method to non-reversible nerve transection and sub-optimal intermittent stimulation methods to reduce dyssynergia.

Effects of pulsed-radiofrequency neuromodulation on the rat with overactive bladder.

To quantify the effects of pulsed radiofrequency (PRF) electrical stimulations of the pudendal and pelvic nerves on the bladder function of rats with detrusor overactivity. All rats were pretreated with a continuous transvesical infusion of 0.5% acetic acid (AA) for inducing detrusor overactivity. Intravesical pressure was recorded using cysometrography (CMG) during the continuous transvesical infusion to examine the effects of PRF electrical stimulation of the pudendal and pelvic nerves individually. In addition, the activity of caspase-3, an apoptosis marker, in the pelvic nerve was examined to evaluate the impact of PRF on nerve injury. According to the first CMG recording, AA treatment significantly reduced bladder capacity (BC) and intercontraction interval (ICI) to 65% and 66% of the corresponding control values, respectively. Subsequently, PRF electrical stimulation of the pelvic nerve inhibited AA-induced detrusor overactivity and significantly increased BC to approximately 102-110% and ICI to 79-92%; these effects persisted for at least 4 h. Furthermore, PRF did not cause significant neural damage to the target stimulated nerves, as demonstrated by caspase-3 activity. PRF electrical stimulation of pelvic nerves exerted a long-lasting effect of suppressing AA-induced detrusor overactivity. This modality can be used as an alternative approach for improving bladder continence in patients with overactive bladder syndrome.

MP86-07 IMPACT OF TISSUE SEALING SHEET ON ERECTILE DYSFUNCTION IN A RAT MODEL OF NERVE-SPARING RADICAL PROSTATECTOMY

You have accessJournal of UrologySexual Function/Dysfunction: Basic Research & Pathophysiology I1 Apr 2016MP86-07 IMPACT OF TISSUE SEALING SHEET ON ERECTILE DYSFUNCTION IN A RAT MODEL OF NERVE-SPARING RADICAL PROSTATECTOMY Shinichi Yamashita, Yoshihiro Kamiyama, Shinji Fujii, Emi Endo, Yoshihide Kawasaki, Hideaki Izumi, Naoki Kawamorita, Koji Mitsuzuka, Hisanobu Adachi, Yasuhiro Kaiho, Akihiro Ito, and Yoichi Arai Shinichi YamashitaShinichi Yamashita More articles by this author , Yoshihiro KamiyamaYoshihiro Kamiyama More articles by this author , Shinji FujiiShinji Fujii More articles by this author , Emi EndoEmi Endo More articles by this author , Yoshihide KawasakiYoshihide Kawasaki More articles by this author , Hideaki IzumiHideaki Izumi More articles by this author , Naoki KawamoritaNaoki Kawamorita More articles by this author , Koji MitsuzukaKoji Mitsuzuka More articles by this author , Hisanobu AdachiHisanobu Adachi More articles by this author , Yasuhiro KaihoYasuhiro Kaiho More articles by this author , Akihiro ItoAkihiro Ito More articles by this author , and Yoichi AraiYoichi Arai More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2315AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Recovery rates for erectile dysfunction (ED) following radical prostatectomy (RP) remain unsatisfactory, even with cavernous nerve (CN)-sparing surgery. We found that ED following CN dissection occurred due to not only technical nerve injury, but also other factors such as inflammatory changes or surgical stress. Intraoperative bleeding, a parameter of the surgical stress, influenced the recovery of erectile function after nerve-sparing RP. A tissue sealing sheet, TachoSil®, has recently been used to prevent intraoperative bleeding in RP. However, the efficacy of tissue sealing sheet for erectile function following nerve-sparing RP remains unclear. We evaluated the effect of tissue sealing sheet on nerve injury-related ED. METHODS Male Sprague-Dawley rats were randomly divided into 3 groups and subjected to sham operation or bilateral CN dissection with or without TachoSil®. In the group with TachoSil®, immediately after CNs were dissected bilaterally from the major pelvic ganglion to the apex of the prostate without crushing or cutting, CNs were sealed with TachoSil®. One urologist performed all operations. Another researcher assessed erectile function by measuring intracavernous pressure (ICP) and mean arterial pressure (MAP) during electrical pelvic nerve stimulation. Erectile function was evaluated 4 weeks postoperatively. Next, expressions of interleukin-6 (IL-6) and tumor growth factor-ß (TGF-ß) mRNA in the major pelvic ganglion (MPG) and CN were examined by real-time polymerase chain reaction at 6 and 24 h after surgery. RESULTS Four weeks after CN dissection, the TachoSil® group showed significantly greater ICP/MAP than the group without TachoSil®. ICP/MAP in the TachoSil® group was similar to that in the sham group. Also, expressions of IL-6 and TGF-ß in both groups with and without TachoSil® were increased at 6 and 24 h after surgery compared with the sham group. Importantly, expressions of IL-6 and TGF-ß in the TachoSil® group were markedly suppressed in the MPG and CN compared with the group without TachoSil®. CONCLUSIONS The TachoSil® tissue sealing sheet attenuated postoperative inflammatory changes and improved erectile function following CN dissection in a rat model of nerve-sparing RP. These results suggested that the tissue sealing sheet may reduce not only intraoperative bleeding, but also inflammatory changes. The tissue sealing sheet may thus represent a useful therapeutic approach to improve ED occurring after nerve-sparing RP, and is available for robotic-assisted laparoscopic prostatectomy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1108 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Shinichi Yamashita More articles by this author Yoshihiro Kamiyama More articles by this author Shinji Fujii More articles by this author Emi Endo More articles by this author Yoshihide Kawasaki More articles by this author Hideaki Izumi More articles by this author Naoki Kawamorita More articles by this author Koji Mitsuzuka More articles by this author Hisanobu Adachi More articles by this author Yasuhiro Kaiho More articles by this author Akihiro Ito More articles by this author Yoichi Arai More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Inhibition of Interleukin‐6 Attenuates Erectile Dysfunction in a Rat Model of Nerve-Sparing Radical Prostatectomy

The precise mechanisms underlying erectile dysfunction (ED) occurring after cavernous nerve (CN)-sparing surgery remain to be determined. Aim. To evaluate the expression of interleukin-6 (IL-6) and IL-6 receptor (IL-6R) after CN injury, and the effect of inhibiting IL-6 bioactivity on nerve injury-related ED. Male Sprague-Dawley rats were divided into three groups: sham operation; bilateral CN dissection without crushing or cutting; and bilateral CN resection. In the interventional experiment, male rats underwent bilateral CN dissection, and anti-rat IL-6 antibody in phosphate-buffered saline (PBS) or vehicle alone was injected intraperitoneally immediately and 24 hours after CN dissection. One, 3, 7, 28, and 56 days after surgery, the expression of IL-6 and IL-6R in the major pelvic ganglion (MPG) was examined by real-time polymerase chain reaction. In the interventional experiment, erectile function was assessed by determining intracavernous pressure divided by arterial pressure (ICP/AP) during electrical pelvic nerve stimulation at 4 weeks after surgery in the anti-IL-6-injected rats and PBS-injected rats. The degree of nerve injury was also evaluated by retrograde dye tracing with Fluorogold. The expression levels of IL-6 and IL-6R were increased in the early period of CN injury, as compared with the sham group. IL-6 expression on day 1 was particularly enhanced. Four weeks after CN dissection, the anti-IL-6 group had greater ICP/AP and more FG-positive cells than the PBS group. Expression levels of IL-6 in the MPG were increased in the acute phase following CN injury. Inhibition of IL-6 bioactivity attenuated ED following CN dissection. Thus, the suppression of excess inflammatory responses in the acute phase may lead to improvements in ED occurring after nerve-sparing radical prostatectomy.

Laparoscopic implantation of neural electrodes on pelvic nerves: an experimental study on the obturator nerve in a chronic minipig model

Laparoscopic exposure of pelvic nerves has opened a new area in the field of neuromodulation. However, electrode design and material deterioration remain issues that limit clinical application. The objective of this study was to evaluate experimentally the laparoscopic implantation of different types of neural electrodes in order to achieve functional and selective electrical stimulation of pelvic nerves. This was a prospective comparative study of the laparoscopic implantation and tolerance and efficacy of three monopolar cuff electrodes implanted on the obturator nerve in ten Göttingen minipigs (18-20 months old; 14.5-24 kg body weight). Animals were allocated to two groups. A 3-mm-diameter laparoscopic instrument was used during dissection of paravesical fossa and obturator nerve on both sides in order to minimize nerve damage. In all animals, a "split-cylinder" cuff electrode was implanted around the left obturator nerve. On the right side, a "lasso" cuff electrode was implanted in the first group and a "closed-cylinder" cuff was implanted in the second group. Electrical stimulation (0-5 V, 20 Hz) was performed for implanted electrodes on days 0, 7, 15, 30, 45, 60, and 90. Current intensity thresholds were identified by palpation of muscle contraction. Strength developed according to stimulation level and was measured using weight transducers. All procedures were performed by laparoscopy. Mean operative times differed significantly among groups, the shortest being for split-cylinder electrodes (P = 0.0002). No electrical spread phenomena were observed. Initial thresholds were below 1.5 V (range = 0.5-1.3); however, a significant rise was observed, with time to a maximum of 2.7 V (P < 0.0001). Only split-cylinder electrodes remained functional after 3 months. The mean value of maximum strength remained stable during the study period (P = 0.21, NS). The laparoscopic approach to implanting neuroprostheses seems to be very attractive. Furthermore, this approach could allow highly selective nerve stimulation to be achieved using simpler devices such as split-cylinder monopolar electrodes.

SPHINGOSINE-1-PHOSPHATE INDUCED CONTRACTION OF HUMAN CORPUS CAVERNOSUM SMOOTH MUSCLE IS MEDIATED BY THE RHO-KINASE PATHWAY AND IS UPREGULATED BY DIABETES, WHILE IN VIVO ADMINISTRATION OF JTE-013 (A SELECTIVE S1P2 RECEPTOR ANTAGONIST) INCREASES INTRACAVERNOUS PRESSURE

You have accessJournal of Urology1 Apr 2009SPHINGOSINE-1-PHOSPHATE INDUCED CONTRACTION OF HUMAN CORPUS CAVERNOSUM SMOOTH MUSCLE IS MEDIATED BY THE RHO-KINASE PATHWAY AND IS UPREGULATED BY DIABETES, WHILE IN VIVO ADMINISTRATION OF JTE-013 (A SELECTIVE S1P2 RECEPTOR ANTAGONIST) INCREASES INTRACAVERNOUS PRESSURE Xin-Hua Zhang, Memduh Aydin, Dwarka S Kuppam, Arnold Melman, and Michael E DiSanto Xin-Hua ZhangXin-Hua Zhang More articles by this author , Memduh AydinMemduh Aydin More articles by this author , Dwarka S KuppamDwarka S Kuppam More articles by this author , Arnold MelmanArnold Melman More articles by this author , and Michael E DiSantoMichael E DiSanto More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(09)60854-5AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "SPHINGOSINE-1-PHOSPHATE INDUCED CONTRACTION OF HUMAN CORPUS CAVERNOSUM SMOOTH MUSCLE IS MEDIATED BY THE RHO-KINASE PATHWAY AND IS UPREGULATED BY DIABETES, WHILE IN VIVO ADMINISTRATION OF JTE-013 (A SELECTIVE S1P2 RECEPTOR ANTAGONIST) INCREASES INTRACAVERNOUS PRESSURE." The Journal of Urology, 181(4S), p. 300 © 2009 by American Urological AssociationFiguresReferencesRelatedDetails Volume 181Issue 4SApril 2009Page: 300 Advertisement Copyright & Permissions© 2009 by American Urological AssociationMetricsAuthor Information Xin-Hua Zhang More articles by this author Memduh Aydin More articles by this author Dwarka S Kuppam More articles by this author Arnold Melman More articles by this author Michael E DiSanto More articles by this author Expand All Advertisement PDF downloadLoading ...

Effects of WAY100635, a selective 5-HT1A-receptor antagonist on the micturition-reflex pathway in the rat.

5-Hydroxytryptamine (5-HT) receptors in the central nervous system have been implicated in the control of micturition. The present study was undertaken to evaluate the effects of a selective 5-HT1A-receptor antagonist [N-[2-[4-(2-methoxyphenyl)-1-piperazinyl]ethyl]-N-(2-pyridinyl)cyclohexanecarboxamide trihydrochloride (WAY100635)] on the micturition-reflex pathway in urethane-anesthetized female Wistar rats. Rhythmic isovolumetric bladder contractions evoked by bladder distension were abolished by 0.3- to 3-mg/kg iv or 30- to 100-microg intrathecal (it) administration of WAY100635 in a dose-dependent manner for periods of 3-15 min. Intrathecal injection of WAY100635 was effective only if injected at the L6-S1 spinal cord level, but not at the thoracic or cervical cord levels. WAY100635 (30-100 microg it) significantly reduced the amplitude of bladder contractions evoked by electrical stimulation of the pontine micturition center. However, the field potentials in the rostral pons evoked by electrical stimulation of pelvic nerve were not affected by intrathecal or intravenous injection of WAY100635. These results suggest that 5-HT1A receptors at the L6-S1 level of the spinal cord have an important role in the tonic control of the descending limb of the micturition-reflex pathway in the rat.

P-411 - Involvement of nitric oxide (NO) on the urinary bladder response to the electrical stimulation of pelvic nerve in rats

P-411 - Involvement of nitric oxide (NO) on the urinary bladder response to the electrical stimulation of pelvic nerve in rats

The effect of pelvic nerve stimulation on recto-anal motility in the cat

Rectal and anal motility responses to pharmacological manipulation of neuro-transmission and graded efferent electrical pelvic nerve stimulation were investigated in alpha-1-chloralose anaesthetized cats. N ω -nitro- l-arginine ( l-NNA), a competitive inhibitor of nitric oxide synthase, did not influence spontaneous rectal and anal motility. No significant change in anal pressure or rectal tone was observed after sectioning the pelvic nerves in animals pretreated with l-NNA. The effect of pelvic nerve stimulation on anal tone was varying and depended upon the intensity of stimulation and the prevailing anal tone. A reduction of anal tone on pelvic nerve stimulation was consistently converted to an increase of anal tone after pretreatment with l-NNA. The rectal response to pelvic nerve stimulation was unchanged by l-NNA. Residual increase of anal tone observed on pelvic nerve stimulation after l-NNA and noradrenergic blockade was partly sensitive to hexamethonium and abolished by atropine. The results suggest that there is no tonic influence on rectal and anal motility via nitric oxide mechanisms. On the other hand, the reduction of anal tone on high intensity pelvic nerve stimulation seemed to be dependent on the release of nitric oxide. An excitatory cholinergic component of the smooth muscle contractility of the feline anal canal, partly sensitive to hexamethonium, was demonstrated to be conveyed in the pelvic nerves.

Renal pelvic pressure isolation from active and passive bladder pressures in the rat: the facilitating effect of urine flow rate.

The circumstances facilitating hydrostatic pressure communication between the bladder and renal pelvis were evaluated. In particular, we compared active detrusor contractions occurring spontaneously during voiding and evoked contractions produced during electrical pelvic nerve stimulation with passive abdominal compression. These variables were evaluated with respect to urine flow rate and bladder capacity. Waveform analysis of the pacemaker characteristics of the renal pelvis shows that the rat pelvis has a narrow frequency band of spontaneous contraction at 0.5 +/- 0.06 Hz. The baseline waveform and pressure of the pelvis is effected by urine flow and bladder capacity. Significant elevations in pelvic pressure of 25.8 +/- 7.9 and 28.7 +/- 5.8 cm H2O were observed for bladder pressures of 30 cm H2O (n = 8) at flow rates in the range of 2.5-5.0 and over 5.0 ml/kg/h respectively (p less than 0.05). At flow rates between 2.5 and 5.0 ml/kg/h, spontaneous contractions produced an increase in pelvic pressure in all rats, while electrical stimulation produced an increase in pelvic pressure in 63%. At flow rates above 5 ml/kg/h, abdominal compression produced sharp elevations in pelvic pressure in 75%. At the same flow rate, electrical stimulation produced a slow increase in 75% and spontaneous contraction produced a slow increase in 86%. These results suggest that the exposure of the upper urinary tract to vesical pressures occurring during active and passive contractions is facilitated by flow.

On the transmission of sacral parasympathetic nervous influence on distal colonic and rectal motility in the cat.

Experiments were performed on cats anaesthetized with chloralose and treated with adrenoceptor blocking agents. Distal colonic and rectal motility were selectively recorded by a volumetric method. The effects of muscarinic and ganglionic nicotine receptor blockade on motor responses induced by graded efferent electrical pelvic nerve stimulation (PNS) were studied. Stimulation at low current strength evoked contractions in both the colon and the rectum, which were sensitive to atropine and to hexamethonium. High intensity stimulation elicited distal colonic contractions resistant to both atropine and hexamethonium. Similar excitatory responses to high strength PNS were also observed in the rectum, though not in all experiments. Stimulation at intermediate intensities evoked distal colonic and rectal relaxations which were resistant to atropine but blocked by hexamethonium. The results indicate that PNS influences colonic and rectal motility by activation of at least three discrete non-adrenergic nervous pathways: (1) low-threshold excitatory fibres involving nicotinic and muscarinic transmission, (2) high-threshold excitatory fibres with a non-muscarinic, non-nicotinic transmission mechanism, (3) inhibitory fibres with an intermediate stimulus intensity threshold, exerting their effect by a non-muscarinic mechanism involving a nicotinic step.