Clinical and experimental study of electrical stimulation for urinary incontinence.

电刺激治疗尿失禁的临床与实验研究。

• 批准号: 03557069
• 负责人: NAKADA Teruhiro
• 金额: $ 7.81万
• 依托单位: Yamagata University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Developmental Scientific Research (B)
• 财政年份: 1991
• 资助国家: 日本
• 起止时间: 1991 至 1993
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-03557069/
• 关键词: pelvic floor stimulation; urinary incontinence; detrusor overactivity; norepinephrine content of the bladder; hypogastric nerve; 神経障害; 過活動性膀胱; ノルエピネフリン

Electrical pelvic floor stimulation using a percutaneous procedure was carried out on 13 patients suffering from urinary incontinence due to overactive detrusor function. After the percutaneous electrode implantation, chronic stimulation was carried out employing portable external electrical stimulator which we developed. 4 to 16 weeks of maximal electrical stimulation improved urinary incontinence in 10 of 13 patients. In 2 of these 10 patients, incontinence disappeared subjectively. Urodynamic investigations demonstrated a increased volume at first unstable contraction in all patients. Inhibition of detrusor overactivity was obtained from this procedure. The stimulation appeared to be constant during chronic stimulation. This procedure can provide stable and reliable stimulation for chronic treatment and can be an alternative for the treatment of urinary incontinence. [Int.Urol.Nephrol., 24 : 277-282, 1992, Eur.Urol., 23 : 413-416, 1993, Frontiers Med.Biol.Engig., 5 : 1-10, 1993, Br.J.Urol., 1994 in press.]We also investigated the basic mechanism of the pelvic floor stimulation. Experiments were carried out to evaluate the regional norepinephrine (NE) content of the rabbit bladder. Content of NE increased in both the bladder base and body significantly after the acute electrical pelvic floor stimulation. Increased NE content sustained 1 to 2 hours after ceasing the stimulation. Based on these findings, during EPFS the hypogastric nerve would play a significant role in bladder inhibition. [J.Urol., 150 : 235-238, 1993, J.Urol., 151 : 774-775, 1994.]

采用经皮电刺激法对13例逼尿肌功能亢进性尿失禁患者进行了盆底电刺激。经皮电极植入后，采用自行研制的便携式体外电刺激器进行慢性刺激。4 - 16周的最大电刺激改善了13例患者中的10例尿失禁。在这10例患者中，2例患者的尿失禁主观消失。尿动力学检查显示所有患者在第一次不稳定收缩时体积增加。从这个过程中获得了逼尿肌过度活动的抑制。在慢性刺激期间，刺激似乎是恒定的。该手术可为慢性治疗提供稳定可靠的刺激，并可作为治疗尿失禁的替代方案。[尿内.肾内.，24：277-282，1992，欧洲，23：413-416，1993，Frontiers Med. Biol. Engig.，5：1-10，1993，Br. J. Urol.，1994年出版）。我们还探讨了盆底刺激的基本机制。本实验测定了家兔膀胱局部去甲肾上腺素（NE）含量。急性电刺激后，膀胱基底部和膀胱体部NE含量均显著增加。停止刺激后1 ~ 2 h内NE含量持续增加。根据这些发现，在EPFS期间，腹下神经在膀胱抑制中起重要作用。[J. Urol.，150：235-238，1993，J. Urol.，151：774-775，1994.]

项目成果

Ishigooka, M., Nakada, T.et al.: "Electrical pelvic floor stimulation by percutaeous implantable electrode." Br.J.Urol.(in press).

Ishigooka, M., Nakada, T.等人：“通过经皮植入式电极进行盆底电刺激。”

Ishigooka,M.,Nakada,T.: "Technique of percutaneous electrode implantation for electrical pelvic floor stimulation." Europ.Urology. 23. 413-416 (1993)

Ishigooka,M.,Nakada,T.：“用于盆底电刺激的经皮电极植入技术。”

石郷岡学,中田瑛浩: "骨盤底筋群電気刺激による膀胱ノルエピネフリン含量の変化" 日本パクプレジア医学会誌. 6. 332-333 (1993)

Manabu Ishigooka、Eihiro Nakata：“盆底肌肉电刺激导致膀胱去甲肾上腺素含量的变化”日本 Pacplesia 医学会杂志 6. 332-333 (1993)。

Ishigooka,M.,Nakada,T.,et al: "Reduction in norepinephrine content of the rabbit urinary bladder by alpha-2 adrenergic antagonist after electrical pelvic floor stimulation." Journal of Urology. 151. 774-775 (1994)

Ishigooka,M.,Nakada,T.,et al：“盆底电刺激后，α-2 肾上腺素能拮抗剂可降低兔膀胱去甲肾上腺素含量。”

Ishigooka, M., Nakada, T.et al.: "Electrical stimulation of pelvic floor musculature by percutaneous implantable electrode : A case report." Int.Urol.Nephrol.24. 277-282 (1992)

Ishigooka, M., Nakada, T.等人：“经皮植入式电极对盆底肌肉组织的电刺激：病例报告。”