Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
BJU Int. 2012 Apr;109(7):1051-8. doi: 10.1111/j.1464-410X.2011.10526.x. Epub 2011 Aug 23.
To determine whether bilateral electrical stimulation (BiES) of the transected pudendal sensory nerves could further enhance the voiding efficiency beyond that produced by unilateral electrical stimulation (UniES) of transected pudendal afferents in rats with urinary retention.
The efficiency of bladder emptying with either UniES or BiES of pudendal nerve afferents was measured after acute bilateral transection of the sensory branch of the pudendal nerve. The effects of UniES and BiES on voiding in a partially denervated bladder and acute spinal transection, respectively, were determined.
The voiding efficiency (VE) was reduced from 69 to 22% after bilateral transection of the sensory branch of the pudendal nerve. UniES or BiES increased the VE to 49-62%. Although in most instances BiES consistently generated more efficient bladder emptying than did UniES, these differences were not significant. Both UniES and BiES increased VE after unilateral pelvic nerve transection, demonstrating efficacy in a partially denervated bladder. The enhancement of VE by either UniES or BiES was preserved after acute T(9)-T(10), demonstrating the spinal origin of this augmenting reflex.
The results of the present study are consistent with an essential role for pudendal sensory feedback in efficient bladder emptying, and unilateral and bilateral electrical activation of pudendal nerve afferents are equally efficient in improving bladder emptying in an animal model of urinary retention. This could provide an approach to improve bladder emptying in patients with non-obstructive urinary retention.
在患有尿潴留的大鼠中,确定双侧阴部感觉神经电刺激(BiES)是否比单侧阴部感觉神经电刺激(UniES)能进一步提高排尿效率。
在急性双侧阴部感觉神经分支切断后,测量单侧阴部感觉神经传入纤维的 UniES 或 BiES 对膀胱排空的效率。分别确定 UniES 和 BiES 对部分去神经化膀胱和急性脊髓切断的影响。
双侧阴部感觉神经分支切断后,排尿效率(VE)从 69%降至 22%。UniES 或 BiES 将 VE 提高至 49-62%。尽管在大多数情况下,BiES 始终比 UniES 产生更有效的膀胱排空,但这些差异并不显著。UniES 和 BiES 均能增加单侧骨盆神经切断后的 VE,表明在部分去神经化膀胱中有效。无论是 UniES 还是 BiES 增强的 VE 都在急性 T(9)-T(10)后保留,证明了这种增强反射的脊髓起源。
本研究结果与阴部感觉反馈在有效膀胱排空中的重要作用一致,单侧和双侧阴部感觉神经传入纤维的电刺激在改善尿潴留动物模型的膀胱排空方面同样有效。这可能为改善非梗阻性尿潴留患者的膀胱排空提供一种方法。