Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
Neurourol Urodyn. 2013 Mar;32(3):293-300. doi: 10.1002/nau.22280. Epub 2012 Jun 5.
Diabetic cystopathy is typically manifested as bladder voiding dysfunction, and numerous patients are refractory to standard therapy. In this study, we determined whether electrical stimulation (ES) of the sensory branch of the pudendal nerve could engage an augmenting reflex and thereby improve bladder emptying in a diabetic animal model with cystopathy.
The efficiency of bladder emptying with ES of the sensory branch of the pudendal nerve at different stimulation intensities was measured in rats at 8 or 18 weeks after the induction of diabetes with streptozotocin.
The voiding efficiency (VE) was reduced from 74 ± 4% to 30 ± 8% in rats with diabetes for 8 weeks and from 73 ± 6% to 20 ± 6% in rats with diabetes for 18 weeks. ES at lower intensities (0.025-0.05 mA) applied to the pudendal sensory nerve did not affect the VE in rats with diabetes for 18 weeks but increased the VE in rats with diabetes for 8 weeks. Subsequently, when the stimulation intensity was elevated to 0.1-0.3 mA, the VEs in rats with diabetes for both 8 and 18 weeks increased to 40-50%.
The results of the present study are consistent with the essential role for pudendal sensory feedback in efficient bladder emptying, and electrical activation of the sensory branch of the pudendal nerve was efficient restoring the voiding function in diabetic animals with cystopathy. This could provide an approach to improve bladder emptying in diabetic patients with voiding dysfunction.
糖尿病性膀胱病通常表现为膀胱排尿功能障碍，许多患者对标准治疗无反应。本研究旨在确定阴部感觉神经分支电刺激（ES）是否能引发增强反射，从而改善糖尿病性膀胱病动物模型的膀胱排空。
在链脲佐菌素诱导糖尿病 8 或 18 周后，测量 ES 刺激阴部感觉神经分支在不同刺激强度下对大鼠膀胱排空的效率。
糖尿病 8 周大鼠的排尿效率（VE）从 74±4%降至 30±8%，糖尿病 18 周大鼠的 VE 从 73±6%降至 20±6%。较低强度（0.025-0.05 mA）的阴部感觉神经 ES 对糖尿病 18 周大鼠的 VE 没有影响，但增加了糖尿病 8 周大鼠的 VE。随后，当刺激强度升高至 0.1-0.3 mA 时，糖尿病 8 周和 18 周大鼠的 VE 均增加至 40-50%。
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，阴部感觉神经分支的电激活在糖尿病性膀胱病动物中恢复排尿功能有效。这可能为改善糖尿病患者排尿功能障碍提供一种方法。
