Department of Urology, Sector FURORE, Erasmus MC, Rotterdam, The Netherlands.
Neurourol Urodyn. 2018 Jun;37(5):1567-1573. doi: 10.1002/nau.23504. Epub 2018 Feb 5.
To test the hypothesis that the frequency of bladder non-voiding contractions (NVCs) can be used as a trigger event for closed-loop conditional inhibition of detrusor contractions via tibial nerve (TN) or dorsal penile nerve (DPN) stimulation.
In urethane anaesthetized male Wistar rats, the bladder was filled continuously with saline to evoke contractions. To test the plausibility of conditional inhibition via the TN, electrical stimulation was switched on manually when the pressure increased above a threshold of 10 cmH 0 above the baseline. For testing conditional stimulation via the DPN, the pressure signal was continuously stored and a baseline threshold, the area under the curve (AUC) of the amplitude spectrum in the 0.2-20 Hz range of a 5 s window at the beginning of filling was calculated. When the AUC of subsequent pressure windows superseded the baseline threshold, the DPN was automatically stimulated.
TN stimulation failed to inhibit evoked voiding contractions. The NVC frequency spectrum based DPN stimulation successfully inhibited 70% of the evoked contractions and resulted in a 45% increase in bladder capacity (BC).
While, conditional TN stimulation failed to suppress bladder contractions, DPN stimulation, automatically triggered by an increased frequency of bladder non-voiding activity, resulted in bladder inhibition, and a consequential increase in BC. This study demonstrates the plausibility of using the frequency of NVCs as a trigger event for conditional inhibition of detrusor contractions.
验证假设,即通过胫神经(TN)或阴茎背神经(DPN)刺激,膀胱非排空收缩(NVC)的频率可作为闭环条件抑制逼尿肌收缩的触发事件。
在乌拉坦麻醉的雄性 Wistar 大鼠中,用生理盐水持续充盈膀胱以引发收缩。为了测试通过 TN 进行条件抑制的合理性,当压力增加超过基线以上 10cmH 0 时,手动开启电刺激。为了通过 DPN 进行条件刺激测试,连续存储压力信号,并计算填充开始时 5s 窗口内 0.2-20Hz 范围内的振幅谱的基线阈值和曲线下面积(AUC)。当随后的压力窗口的 AUC 超过基线阈值时,DPN 自动被刺激。
TN 刺激未能抑制诱发的排尿收缩。基于 NVC 频率谱的 DPN 刺激成功抑制了 70%的诱发收缩,并使膀胱容量(BC)增加了 45%。
虽然条件性 TN 刺激未能抑制膀胱收缩,但 DPN 刺激,通过增加膀胱非排空活动的频率自动触发,导致膀胱抑制和 BC 的相应增加。这项研究证明了使用 NVC 频率作为条件抑制逼尿肌收缩的触发事件的合理性。