Rakovec S, Plevnik S, Kralj B
Urol Int. 1977;32(2-3):232-7. doi: 10.1159/000280136.
The mechanisms of the action of electrical stimulation of muscles are discussed. We believe that the principal cause for the good results obtained in cases of stress incontinence with electrical stimulation must be due to the formation of a better reflex in contraction of the muscles of the pelvic floor. This, however, envolves changes at the level of the spinal cord. By the help of stimulation the patient learns to use the urethral sphincter and secondary forces of retention in a better and a more proper way. The good results obtained in the treatment of some cases of nocturnal enuresis by anal plugs require yet another explanation. It can be considered that in nocturnal enuresis the unconscious inhibition of the reflex mechanism for emptying the bladder is not developed enough. From the experience we know that vigorous voluntary activation of the muscles of the pelvic floor inhibits the contraction of the detrusor muscle. In this way it is possible to depress the urging sensation to urinate. In the paper we have tried to demonstrate this mechanism objectively. On the basis of our findings we believe that the good results in treating nocturnal enuresis may be due to this mechanism of stimulation.
本文讨论了肌肉电刺激的作用机制。我们认为，在压力性尿失禁病例中，通过电刺激取得良好效果的主要原因一定是盆底肌肉收缩时形成了更好的反射。然而，这涉及脊髓层面的变化。借助刺激，患者学会以更好、更恰当的方式使用尿道括约肌和继发性的憋尿力量。通过肛门塞治疗某些夜间遗尿症病例所取得的良好效果则需要另作解释。可以认为，在夜间遗尿症中，膀胱排空反射机制的无意识抑制发育不足。从经验中我们知道，盆底肌肉的强烈自主激活会抑制逼尿肌的收缩。这样就有可能抑制排尿的冲动感。在本文中，我们试图客观地证明这一机制。基于我们的研究结果，我们认为治疗夜间遗尿症取得良好效果可能归因于这种刺激机制。
