Implantable selective stimulator to improve bladder voiding: Design and chronic experiments in dogs
Implantable selective stimulator to improve bladder voiding: Design and chronic experiments in dogs
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DOI：
10.1109/86.895949
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发表时间：
2000-12-01
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影响因子：
--
通讯作者：
Elhilali, MM
中科院分区：
文献类型：
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作者：
Boyer, S;Sawan, M;Elhilali, MM
在促进膀胱排尿的治疗方法中，骶神经根电刺激是最有前途的方法之一。电刺激骶神经可引起逼尿肌和尿道外括约肌同时收缩，本文设计了一种新型的植入式骶神经电刺激器及其无线控制器，用于研究高频抑制刺激策略。这种基于高频抑制的创新技术减少了刺激过程中的括约肌活动。低频电流脉冲也施加到骶神经根诱导逼尿肌收缩，导致低压排尿。在10只雄性杂种犬上进行慢性实验，每个刺激器沿着植入一个袖状电极，持续8个月。使用我们的可植入选择性刺激器的原型每天刺激动物两次，同时在手术期间测量排尿量和残余尿量。这些实验表明，与仅低频刺激相比，所提出的刺激策略使膀胱排尿增加超过50%。术后残余尿量平均减少9%，膀胱尿道造影显示患者均能实现低压排尿。
Among the treatments to enhance the bladder voiding, the sacral roots neurostimulation is one of the most promising techniques. The electrostimulation of sacral nerves provokes a simultaneous contraction of the detrusor muscle as well as the external urethral sphincter (EUS), A new simplified-architecture implantable stimulator with its wireless controller have been designed to investigate high-frequency inhibition stimulation strategies. This innovative technique based on high-frequency inhibition reduces sphincter activity during stimulation. Low-frequency current pulses also applied to the sacral roots induces contraction of the detrusor muscle resulting in low pressure voiding. Chronic experiments were carried out on ten male mongrel paraplegic dogs, One cuff electrode was implanted along with each stimulator for eight months. The animals were stimulated twice a day using the prototypes of our implantable selective stimulator while voided and residual urine volume were measured during the procedure, These experiments revealed that the proposed stimulation strategy enhances bladder voiding by more than 50% in comparison with low-frequency only stimulation. The residual urine volume was reduced to an average of 9% and low pressure micturition was achieved as shown by weekly cystourethrogram.