Walter James S, Fitzgerald Mary Pat, Wheeler John S, Orris Bradley, McDonnell Allison, Wurster Robert D
Research Service, Department of Veterans Affairs (VA) Edward Hines Jr. Hospital, Hines, IL 60141, USA.
J Rehabil Res Dev. 2005 Mar-Apr;42(2):251-60.
Severe urinary retention is not a common condition, but may occur following some pelvic surgeries or other medical conditions. Electrical stimulation of the bladder has been examined as a means of managing this difficult problem. We conducted preliminary investigations in cats to prove the hypothesis that pelvic-plexus (bladder-neck) stimulation would produce greater micturition response with reduced side effects, such as animal movement or discomfort, than bladder-wall stimulation with electrodes implanted higher on the bladder wall. We used model microstimulators that mimic the look and function of commercial microstimulators, but that we constructed. We instrumented four female cats during a survival surgery. Animals recovered well and studies were conducted over a 1-month period in the conscious animal and under anesthesia. We performed a variety of studies with different stimulation parameters and electrode locations to evaluate our hypothesis. In the active animal, we supplied only low currents, but two animals responded to stimulation with bladder contractions and voiding. Following anesthesia, higher stimulating currents resulted in greater bladder contractions during stimulation in two of the three animals. In two cases, pelvic-plexus (bladder-neck) stimulation induced greater micturition responses than direct bladder-wall stimulation. In conclusion, we learned from these preliminary observations that stimulation at the pelvic plexus (bladder neck) may induce a better micturition response than stimulation higher on the bladder-wall. Newly available commercial microstimulators should be further studied for the treatment of urinary retention.
严重尿潴留并不常见，但可能在一些盆腔手术后或其他疾病情况下发生。膀胱电刺激已被作为解决这一难题的一种方法进行研究。我们在猫身上进行了初步研究，以证明以下假设：与在膀胱壁较高位置植入电极进行膀胱壁刺激相比，盆腔神经丛（膀胱颈）刺激会产生更大的排尿反应，且副作用（如动物活动或不适）减少。我们使用了模仿商用微刺激器外观和功能但由我们自行构建的模型微刺激器。在一次存活手术中，我们对四只雌性猫进行了仪器植入。动物恢复良好，并在清醒动物和麻醉状态下进行了为期1个月的研究。我们用不同的刺激参数和电极位置进行了各种研究，以评估我们的假设。在清醒动物中，我们只提供低电流，但有两只动物对刺激产生了膀胱收缩和排尿反应。麻醉后，三只动物中有两只在刺激期间，较高的刺激电流导致了更大的膀胱收缩。在两个案例中，盆腔神经丛（膀胱颈）刺激比直接膀胱壁刺激诱导出了更大的排尿反应。总之，从这些初步观察中我们了解到，盆腔神经丛（膀胱颈）刺激可能比膀胱壁较高位置的刺激诱导出更好的排尿反应。新上市的商用微刺激器应进一步研究用于治疗尿潴留。
