High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats.
High Frequency Stimulation of the Pelvic Nerve Inhibits Urinary Voiding in Anesthetized Rats.
复制标题
DOI：
10.3389/fphys.2017.00623
复制
发表时间：
2017
影响因子：
4
通讯作者：
Lovick TA
中科院分区：
文献类型：
--
作者：
Crook JJ;Lovick TA
急迫性尿失禁：“一种突然的、无法控制的、无法推迟的排尿欲望”是非常常见的，被认为是下尿路疾病中最麻烦的。目前的治疗依赖于药物、神经调节和神经毒理学方法，通过降低膀胱肌肉的兴奋性来控制这种疾病。然而，一些患者仍然难以治疗。另一种方法是在需要的时候暂时抑制排尿控制电路的活动，即紧急情况。在这项研究中，我们在大鼠模型中研究了高频盆腔神经刺激对排尿产生快速发作、可逆抑制的效用。在尿道外括约肌（EUS）电活动和膀胱压力记录的同时，连续向膀胱内注入生理盐水诱导大鼠周期性排尿。高频（1-3千赫），正弦骨盆神经刺激开始时，膀胱压力急剧上升，信号即将空虚中止逼尿肌收缩。尿量被抑制，EUS张力增高。刺激右侧或左侧神经同样有效。效果起效快、可逆、可重复性好，对血压、心率、呼吸、子宫压或直肠压的“脱靶”副作用极小。部分动物出现一过性腹壁收缩。在充血期施加的刺激引起膀胱压力短暂的小幅上升和EUS的强直活动增加，但没有尿量。切除对侧盆腔神经或结扎同侧电极袖远端神经后，排尿抑制持续存在。我们的结论是，高频盆腔神经刺激的开始迫在眉睫的空虚提供了一个潜在的手段来控制尿失禁。
Urge Urinary Incontinence: “a sudden and uncontrollable desire to void which is impossible to defer” is extremely common and considered the most bothersome of lower urinary tract conditions. Current treatments rely on pharmacological, neuromodulatory, and neurotoxicological approaches to manage the disorder, by reducing the excitability of the bladder muscle. However, some patients remain refractory to treatment. An alternative approach would be to temporarily suppress activity of the micturition control circuitry at the time of need i.e., urgency. In this study we investigated, in a rat model, the utility of high frequency pelvic nerve stimulation to produce a rapid onset, reversible suppression of voiding. In urethane-anesthetized rats periodic voiding was induced by continuous infusion of saline into the bladder whilst recording bladder pressure and electrical activity from the external urethral sphincter (EUS). High frequency (1–3 kHz), sinusoidal pelvic nerve stimulation initiated at the onset of the sharp rise in bladder pressure signaling an imminent void aborted the detrusor contraction. Urine output was suppressed and tone in the EUS increased. Stimulating the right or left nerve was equally effective. The effect was rapid in onset, reversible, and reproducible and evoked only minimal “off target” side effects on blood pressure, heart rate, respiration, uterine pressure, or rectal pressure. Transient contraction of abdominal wall was observed in some animals. Stimulation applied during the filling phase evoked a small, transient rise in bladder pressure and increased tonic activity in the EUS, but no urine output. Suppression of micturition persisted after section of the contralateral pelvic nerve or after ligation of the nerve distal to the electrode cuff on the ipsilateral side. We conclude that high frequency pelvic nerve stimulation initiated at the onset of an imminent void provides a potential means to control urinary continence.
登录
查看更多内容
DOI：
10.1111/ner.12100
发表时间：
2014-04
期刊：
Neuromodulation : journal of the International Neuromodulation Society
影响因子：
--
作者：
Kilgore KL;Bhadra N
通讯作者：
Bhadra N
影响因子：
3.3
作者：
Crook J;Lovick T
通讯作者：
Lovick T
影响因子：
2
作者：
Aronsson, Patrik;Carlsson, Thomas;Tobin, Gunnar
通讯作者：
Tobin, Gunnar
影响因子：
5.5
作者：
DEGROAT, WC;RYALL, RW
通讯作者：
RYALL, RW
影响因子：
2.5
作者：
HULSEBOSCH, CE;COGGESHALL, RE
通讯作者：
COGGESHALL, RE