Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania.
Department of Urology, Qianfoshan Hospital, Shandong University , Jinan , People's Republic of China.
Am J Physiol Renal Physiol. 2018 Aug 1;315(2):F247-F253. doi: 10.1152/ajprenal.00422.2017. Epub 2017 Oct 25.
This study in α-chloralose-anesthetized cats aimed at investigating the bladder responses to saphenous nerve stimulation (SNS). A urethral catheter was used to infuse the bladder with saline and to record changes in bladder pressure. With the bladder fully distended, SNS at 1-Hz frequency and an intensity slightly below the threshold (T) for inducing an observable motor response of the hindlimb muscles induced large amplitude (40-150 cmHO) bladder contractions. Application of SNS (1 Hz, 2-4T) during cystometrograms (CMGs), when the bladder was slowly (1-3 ml/min) infused with saline, significantly ( P < 0.05) increased the duration of the micturition contraction to >200% of the control without changing bladder capacity or contraction amplitude. Repeated application (1-8 times) of intense (4-8T intensity) 30-min tibial nerve stimulation (TNS) produced prolonged post-TNS inhibition that significantly ( P < 0.01) increased bladder capacity to 135.9 ± 7.6% and decreased the contraction amplitude to 44.1 ± 16.5% of the pre-TNS control level. During the period of post-TNS inhibition, SNS (1 Hz, 2-4T) applied during CMGs completely restored the bladder capacity and the contraction amplitude to the pre-TNS control level and almost doubled the duration of the micturition contraction. These results indicate that SNS at 1 Hz can facilitate the normal micturition reflex and normalize the reflex when it is suppressed during post-TNS inhibition. This study provides an opportunity to develop a novel neuromodulation therapy for underactive bladder using SNS.
本研究在α-氯醛糖麻醉的猫中旨在研究刺激隐神经(SNS)对膀胱的反应。使用尿道导管向膀胱内输注生理盐水并记录膀胱压力变化。当膀胱完全扩张时,以 1Hz 频率和略低于引起后肢肌肉可观察到运动反应的阈值(T)的强度刺激 SNS,会引起大振幅(40-150cmHO)的膀胱收缩。在膀胱以 1-3ml/min 的缓慢速度输注生理盐水时,在膀胱测压图(CMG)期间施加 SNS(1Hz,2-4T),会显著(P<0.05)将排尿收缩的持续时间延长至对照的>200%,而不改变膀胱容量或收缩幅度。强烈(4-8T 强度)30 分钟重复施加胫骨神经刺激(TNS)会产生延长的 post-TNS 抑制,这会显著(P<0.01)将膀胱容量增加到对照的 135.9±7.6%,并将收缩幅度降低到对照的 44.1±16.5%。在 post-TNS 抑制期间,在 CMG 期间施加的 1Hz、2-4T 的 SNS 可完全将膀胱容量和收缩幅度恢复到对照的 pre-TNS 水平,并将排尿收缩的持续时间几乎增加一倍。这些结果表明,1Hz 的 SNS 可以促进正常的排尿反射,并在 post-TNS 抑制期间抑制反射时使其正常化。本研究为使用 SNS 为不活跃性膀胱开发新型神经调节疗法提供了机会。