Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
J Urol. 2011 Jul;186(1):326-30. doi: 10.1016/j.juro.2011.04.023. Epub 2011 May 20.
We investigated the effects of tibial nerve stimulation on bladder overactivity induced by acetic acid irritation.
Cystometry was performed in 10 α-chloralose anesthetized female cats by infusing saline or acetic acid through a urethral catheter that was secured by a ligature around the urethra. Intravesical infusion of 0.25% acetic acid was used to irritate the bladder and induce bladder overactivity. Multiple cystometrograms were done before, during and after tibial nerve stimulation to determine the inhibitory effect on the micturition reflex.
Infusion of 0.25% acetic acid irritated the bladder, induced bladder overactivity and significantly decreased bladder capacity to about 20% of control capacity measured during saline infusion. Tibial nerve stimulation at low (5 Hz) or high (30 Hz) frequency significantly increased bladder capacity to about 40% of saline control capacity when it was applied during acetic acid infusion cystometrogram. Bladder contraction amplitude was smaller during acetic acid irritation than during saline distention due to significantly smaller bladder capacity. Tibial nerve stimulation at 5 Hz increased bladder capacity and bladder contraction amplitude.
Activation of somatic afferents in the tibial nerve of cats can partially reverse the bladder overactivity induced by intravesical administration of a chemical irritant that activates C-fiber afferent nerves. These data are consistent with clinical studies showing that tibial nerve neuromodulation is effective treatment for overactive bladder symptoms.
我们研究了胫神经刺激对乙酸刺激引起的膀胱过度活动的影响。
通过尿道导管向 10 只α-氯醛麻醉的雌性猫的膀胱内输注生理盐水或乙酸，通过结扎尿道周围的尿道导管将其固定。通过向膀胱内输注 0.25%的乙酸来刺激膀胱并引起膀胱过度活动。在胫神经刺激前后进行多次膀胱测压，以确定对排尿反射的抑制作用。
输注 0.25%的乙酸刺激膀胱，引起膀胱过度活动，并使膀胱容量显著降低至生理盐水输注期间测量的对照容量的约 20%。当在乙酸输注膀胱测压期间应用时，低（5Hz）或高（30Hz）频率的胫神经刺激可使膀胱容量增加到生理盐水对照容量的约 40%。由于膀胱容量明显较小，因此在乙酸刺激期间膀胱收缩幅度小于在生理盐水扩张期间。5Hz 的胫神经刺激增加了膀胱容量和膀胱收缩幅度。
激活猫的胫神经体传入纤维可以部分逆转由激活 C 纤维传入神经的膀胱内化学刺激引起的膀胱过度活动。这些数据与临床研究一致，表明胫神经神经调节是治疗膀胱过度活动症状的有效方法。
