Seif C, Cherwon E, Martinez Portilló F J, Alken P, Jünemann K P, Braun P M
Department of Urology, University Hospital Kiel, Germany.
BJU Int. 2003 May;91(7):711-5. doi: 10.1046/j.1464-410x.2003.04185.x.
To investigate different stimulation signals for the peripheral nerve evaluation test (PNE, carried out before implanting a sacral neuromodulator for functional voiding dysfunction) in an animal model and to determine their efficacy, as up to 80% of patients do not respond to the PNE test.
PNE foramen electrodes were placed in the S3 of 12 anaesthetized Göttingen minipigs. First, detrusor instabilities were induced by the intravesical instillation of formalin. A 10-min stimulation phase with both a quasi-trapezoidal (QT) signal and a rectangular signal followed. An interval of 30 min elapsed between the series of stimulations. The attained bladder 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 a control group.
After formalin instillation, the mean (sd) number of involuntary detrusor contractions was 3.5 (0.8)/min and the sum of amplitudes 7.2 (1.1) cmH2O/min. Subsequent NaCl instillation and QT-stimulation reduced the contractions to 0.3 (0.3)/min and the sum of amplitudes to 0.8 (0.4) cmH2O/min. Stimulation with a rectangular signal, as used in the PNE test, followed after an interval of 10 min, giving 1.1 (0.1) contractions/min and a sum of amplitudes of 5.1 (2.4) cmH2O/min. Within the control group there was no significant reduction.
These results show that QT-stimulation suppresses uncontrollable detrusor contractions in the minipig more effectively than the conventional rectangular stimulation presently applied in sacral neuromodulation.
在动物模型中研究用于周围神经评估测试（PNE，在植入骶神经调节装置治疗功能性排尿功能障碍之前进行）的不同刺激信号，并确定其疗效，因为高达80%的患者对PNE测试无反应。
将PNE孔电极置于12只麻醉的哥廷根小型猪的S3处。首先，通过膀胱内灌注福尔马林诱导逼尿肌不稳定。随后进行10分钟的刺激阶段，分别采用准梯形（QT）信号和矩形信号。两次刺激系列之间间隔30分钟。在尿动力学装置上记录获得的膀胱压力值，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，逼尿肌非自主性收缩的平均（标准差）次数为3.5（0.8）次/分钟，幅度总和为7.2（1.1）cmH₂O/分钟。随后灌注氯化钠并进行QT刺激后，收缩次数降至0.3（0.3）次/分钟，幅度总和降至0.8（0.4）cmH₂O/分钟。10分钟后采用PNE测试中使用的矩形信号进行刺激，得到1.1（0.1）次/分钟的收缩次数和5.1（2.4）cmH₂O/分钟的幅度总和。对照组无显著降低。
这些结果表明，QT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不可控的逼尿肌收缩。
