Braun P M, Seif C, Bross S, Martinez Portillo F J, Alken P, Jünemann K P
Department of Urology, University Hospital Kiel, Kiel, Germany.
Urology. 2003 Apr;61(4):839-44. doi: 10.1016/s0090-4295(02)02403-2.
To investigate, in an experimental study, the efficacy of a different stimulation signal in a porcine model to suppress formalin-induced unstable detrusor contractions. The current mode of stimulation in peripheral nerve evaluation tests and sacral neuromodulation is based on rectangular signal shapes. Published reports, however, have revealed that up to 80% of patients do not respond to peripheral nerve evaluation stimulation.
After placement of electrodes at S3 in 12 anesthetized Göttinger minipigs, unstable contractions were induced by intravesical instillation of formalin. Ten-minute stimulation phases with a quasi-trapezoidal signal and a rectangular signal followed. An interval of 30 minutes elapsed between the two series of stimulations. The pressure values were registered on a urodynamic unit and evaluated as contractions and amplitudes per minute. Six minipigs were treated in the same way but were not stimulated and served as the control group.
After formalin instillation, the average number of involuntary detrusor contractions was 3.5/min (+/- 0.8) and the sum of amplitudes was 7.2/min (+/- 1.1). Subsequent NaCl instillation and quasi-trapezoidal stimulation reduced the contractions to 0.3/min (+/- 0.3) and the sum of amplitudes to 0.8/min (+/- 0.4). A contraction rate of 1.1/min (+/- 0.1) and a sum of amplitudes of 5.1/min (+/- 2.4) were recorded under stimulation with a rectangular signal. In the control group, no significant reduction was recorded.
The acquired data demonstrate that quasi-trapezoidal stimulation suppresses unstable detrusor contractions in the minipig more effectively than does conventional rectangular stimulation as presently applied in sacral neuromodulation.
在一项实验研究中，探究在猪模型中不同刺激信号抑制福尔马林诱导的逼尿肌不稳定收缩的效果。目前外周神经评估测试和骶神经调节中的刺激模式基于矩形信号形状。然而，已发表的报告显示，高达80%的患者对外周神经评估刺激无反应。
在12只麻醉的哥廷根小型猪的S3处放置电极后，通过膀胱内灌注福尔马林诱导不稳定收缩。随后分别用准梯形信号和矩形信号进行10分钟的刺激阶段。两组刺激之间间隔30分钟。在尿动力学装置上记录压力值，并评估每分钟的收缩次数和幅度。6只小型猪以相同方式处理但不进行刺激，作为对照组。
灌注福尔马林后，逼尿肌非自主收缩的平均次数为3.5次/分钟（±0.8），幅度总和为7.2次/分钟（±1.1）。随后灌注生理盐水并进行准梯形刺激后，收缩次数降至0.3次/分钟（±0.3），幅度总和降至0.8次/分钟（±0.4）。在矩形信号刺激下，记录到的收缩率为1.1次/分钟（±0.1），幅度总和为5.1次/分钟（±2.4）。对照组未记录到显著降低。
所获得的数据表明，准梯形刺激比目前骶神经调节中应用的传统矩形刺激更有效地抑制小型猪逼尿肌的不稳定收缩。
