Langdale Christopher L, Grill Warren M
Department of Biomedical Engineering, Duke University, Durham, NC, USA.
Department of Biomedical Engineering, Duke University, Durham, NC, USA; Department of Electrical and Computer Engineering, Duke University, Durham, NC, USA; Department of Neurobiology, Duke University, Durham, NC, USA; Department of Surgery, Duke University, Durham, NC, USA.
Exp Neurol. 2016 Nov;285(Pt B):173-181. doi: 10.1016/j.expneurol.2016.05.030. Epub 2016 May 25.
Electrical stimulation of the pudendal nerve (PN) is a potential therapy for bladder dysfunction, but voiding efficiency (VE) produced by PN stimulation appears limited to 60-70%. We conducted experiments in rats and cats to investigate the hypothesis that introduction of artificial phasic bursting activity of the external urethral sphincter (EUS) would enhance VE under conditions where such activity was absent.
Cystometry experiments were conducted in 17 urethane anesthetized female Sprague-Dawley rats and 4 α-chloralose anesthetized male cats. The effects of phasic stimulation of the pudendal motor branch on VE were quantified in intact conditions, following bilateral transection of the motor branch of the PN, and following subsequent bilateral transection of the sensory branch of the PN.
Artificial phasic bursting activity in the EUS generated by electrical stimulation of the motor branch of the PN increased VE in both rats and cats. Subsequent transection of the sensory branch of the PN abolished the increased VE elicited by phasic stimulation in both rats and cats.
Artificial phasic EUS bursting restored efficient voiding in rats. Introduction of artificial phasic bursting in cats, which normally exhibit EUS relaxation while voiding, was also effective in promoting efficient voiding. In both species phasic EUS activity increased voiding efficiency via activation of pudendal sensory pathways. These results provide further insight into the function of phasic EUS activity in efficient voiding and highlight a novel approach to increase VE generated by pudendal afferent nerve stimulation.
阴部神经(PN)电刺激是治疗膀胱功能障碍的一种潜在疗法,但PN刺激产生的排尿效率(VE)似乎仅限于60%-70%。我们在大鼠和猫身上进行了实验,以研究在缺乏这种活动的情况下,引入尿道外括约肌(EUS)的人工相位爆发活动是否会提高VE。
对17只经乌拉坦麻醉的雌性Sprague-Dawley大鼠和4只经α-氯醛糖麻醉的雄性猫进行膀胱测压实验。在完整状态下、双侧切断PN运动支后以及随后双侧切断PN感觉支后,对阴部运动支的相位刺激对VE的影响进行量化。
通过电刺激PN运动支在EUS中产生的人工相位爆发活动增加了大鼠和猫的VE。随后切断PN感觉支消除了相位刺激在大鼠和猫中引起的VE增加。
人工相位EUS爆发恢复了大鼠的有效排尿。在正常排尿时表现为EUS松弛的猫中引入人工相位爆发,对促进有效排尿也有效。在这两个物种中,相位EUS活动通过激活阴部感觉通路提高了排尿效率。这些结果进一步深入了解了相位EUS活动在有效排尿中的功能,并突出了一种增加阴部传入神经刺激产生的VE的新方法。