Functional reconstruction of incontinence and voiding disorder due to supranuclear neurogenic bladder by the functional electrical stimulation.

本研究旨在解决电刺激骶前神经根引起的逼尿肌-括约肌协同失调，并应用功能性电刺激重建排尿功能。1）刺激器的研制：研制了双通道/二相刺激器，实现了双通道的多路调制刺激。该刺激器的特点是仅通过给定与各参数成正比的控制电压就能产生脉冲宽度、幅度和频率。2）横纹尿道括约肌对刺激频率的反应：用成年雄性犬获得了横纹尿道括约肌的临界融合频率。5 Hz、10 Hz、20 Hz、30 Hz和50 Hz的平均融合指数分别为0%、3.4%、54.7%、85.1%和100%。因此，临界融合频率似乎是50 Hz和/或更高。 ...更多信息 高频阻断对横纹尿道括约肌压力的影响：从横纹尿道括约肌对高频刺激的反应性来检查阻断刺激的可能性。在300 Hz的刺激下，观察到由明显的肌肉疲劳引起的压力降低。另一方面，在3000 Hz刺激下，除了刺激开始和结束时的尖峰样压力升高外，尿道内压在刺激下完全不升高。这一发现似乎表明了麻痹作用。然后，我们研究了50 Hz刺激阴部神经和3000 Hz条件刺激对尿道内压的影响。我们预计，尿道内压力上升到50 Hz刺激是完全抑制由3000 Hz条件刺激。这是因为3000 Hz条件刺激使尿道括约肌神经肌肉接头内的递质耗竭。3000 Hz条件刺激对50 Hz刺激的尿道内压力反应无影响。少

The aim of this study is to resolve detrusor-sphincter dyssynergia which is generated the electrical stimulation of the anterior sacral nerve root, and to reconstruct the voiding function using the functional electrical stimulation. In present study, following research results were obtained.1) The development of the stimulator : We developed 2channel/2phase stimulator of which the multiple modulated stimulation of the 2 channels was possible. The features of this stimulator are to produce pulse duration, amplitude and frequency only by giving control voltage which is to each parameter in direct proportion.2) The response of striated urethral sphincter for the stimulation frequency : The critical fusion frequency of striated urethral sphincter was obtained using the adult male dogs. The average fusion index at 5Hz, 10Hz, 20Hz, 30Hz and 50Hz were 0%, 3.4%, 54.7%, 85.1% and 100%, respectively. Therefore, the critical fusion frequency seemed to be 50Hz and/or above it.3) The effect of the … More high-frequency blockade for striated urethral sphincter pressure : The possibility of the block stimulation was examined from the reactivity of striated urethral sphincter for the high frequency stimulation. In the stimulation of 300Hz, the lowering of the pressure by the patent muscle fatigue was observed. On the other hand, in the 3000Hz stimulation, it completely did not rise under stimulation on the intraurethral pressure except for the spike like pressure rising in start and end of the stimulation. It seemed that this finding indicates paralytic effect. Then, we studied the change of the intraurethral pressure for the 50Hz stimulation to the pudendal nerve with or without 3000Hz conditioning stimulus. We anticipated that the rise in the intraurethra pressure to the 50Hz stimulation was perfectly suppressed by the 3000Hz conditioned stimulus. Because, the transmitter in neuromuscular junction of striated urethral sphincter was exhausted by 3000Hz conditioned stimulus. However, 3000Hz conditioned stimulus did not affect intraurethral pressure reaction for the 50Hz stimulation at all. Less