Kennelly Michael J, Bennett Maria E, Grill Warren M, Grill Julie H, Boggs Joseph W
Carolinas Rehabilitation, Urology Department, Charlotte, NC, USA.
J Spinal Cord Med. 2011;34(3):315-21. doi: 10.1179/2045772311Y.0000000012.
Electrical stimulation of the urethra can evoke bladder contractions in persons with spinal cord injury (SCI). The objective of this study was to determine whether electrical stimulation of the urethra could evoke bladder contractions that empty the bladder.
The first patient was a 45-year-old man with a T6 ASIA A SCI secondary to a gunshot wound 15 years prior. The second patient was a 51-year-old man with a T2 ASIA A SCI secondary to a fall from scaffolding 2 years prior. Both patients demonstrated neurogenic detrusor overactivity on urodynamics and managed their bladder with clean intermittent catheterization and oxybutynin medication. Following informed consent, each patient discontinued oxybutynin 2 days prior to urodynamic testing. Urodynamics were performed with a custom 12 French balloon catheter mounted with ring-shaped electrodes (3 mm) positioned in the prostatic urethra. After filling the bladder to approximately three-fourth of capacity at a rate of 25 ml/minute, the urethra was stimulated with a range of parameters to determine whether electrical stimulation could evoke a bladder contraction and empty the bladder.
Electrical stimulation of the prostatic urethra evoked bladder contractions (peak detrusor pressures of 60-80 cm H(2)O) that emptied the bladder in both subjects. In the first subject, stimulation (9-12 mA, 20 Hz) emptied 64-75%, leaving post-void residual volumes (PVRs) of 41-20 ml. In the second subject, stimulation (20 mA, 20 Hz) emptied 68-77%, leaving PVRs of 56-45 ml.
Urethral stimulation evoked bladder emptying in persons with SCI.
对脊髓损伤（SCI）患者进行尿道电刺激可诱发膀胱收缩。本研究的目的是确定尿道电刺激是否能诱发膀胱收缩并使膀胱排空。
首例患者为一名45岁男性，15年前因枪伤导致T6级亚洲脊髓损伤协会（ASIA）A 级损伤。第二例患者为一名51岁男性，2年前因从脚手架上跌落导致T2级ASIA A级损伤。两名患者在尿动力学检查中均表现为神经源性逼尿肌过度活动，通过清洁间歇性导尿和使用奥昔布宁药物来管理膀胱。在获得知情同意后，每位患者在尿动力学检查前2天停用奥昔布宁。使用定制的12法式球囊导管进行尿动力学检查，该导管安装有位于前列腺尿道的环形电极（3毫米）。以25毫升/分钟的速率将膀胱充盈至容量的约四分之三后，用一系列参数刺激尿道，以确定电刺激是否能诱发膀胱收缩并使膀胱排空。
对前列腺尿道进行电刺激可诱发膀胱收缩（逼尿肌峰值压力为60 - 80厘米水柱），使两名受试者的膀胱均排空。在首例受试者中，刺激（9 - 12毫安，20赫兹）使膀胱排空64 - 75%，残余尿量（PVR）为41 - 20毫升。在第二例受试者中，刺激（20毫安，20赫兹）使膀胱排空68 - 77%，PVR为56 - 45毫升。
尿道刺激可使SCI患者的膀胱排空。
