Department of Electrical and Computer Engineering, College of Engineering, Temple University, Philadelphia, Pennsylvania, United States of America.
Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, United States of America.
PLoS One. 2019 Apr 10;14(4):e0215036. doi: 10.1371/journal.pone.0215036. eCollection 2019.
We aimed to refine electroneurogram techniques for monitoring hypogastric nerve activity during bladder filling, and then examined nerve activity in normal intact versus acutely decentralized bladders.
Effects of electrical stimulation of hypogastric nerves or lumbar ventral roots on detrusor pressure were examined, as were effects of isoflurane versus propofol anesthetics on hypogastric nerve stimulation evoked pressure. Hypogastric nerve activity was then recorded using custom-made bipolar cuff electrodes during bladder filling before and after its transection between the spinal cord and electrode to eliminate efferent nerve signals.
Electrical stimulation of hypogastric nerves evoked low amplitude detrusor pressures that did not differ between the two anesthetics. Upper lumbar (L2) ventral root stimulation evoked detrusor pressures were suppressed, yet not eliminated, after transection of hypogastric nerves and all spinal roots below L5. Afferent and efferent hypogastric nerve activity did not change with bladder filling in neuronally intact bladders yet decreased in decentralized bladders. No change in afferent activity was observed during bladder filling in either intact or decentralized bladders.
These findings indicate that a more complete decentralized bladder model should include transection of lumbosacral spinal roots innervating the bladder as well as hypogastric nerves. These refined electroneurogram recording methods may be suitable for evaluating the effectiveness of nerve transfer surgeries for bladder reinnervation by monitoring sensory activity in the transferred nerve.
我们旨在改进电神经图技术,以监测膀胱充盈过程中的阴部神经活动,然后检查正常完整和急性去神经化膀胱的神经活动。
研究了阴部神经或腰腹根电刺激对逼尿肌压力的影响,以及异氟醚与异丙酚麻醉对阴部神经刺激诱发压力的影响。然后,在膀胱切断前后使用定制的双极袖套电极记录阴部神经活动,以消除传出神经信号。
阴部神经电刺激诱发的逼尿肌压力幅度较低,两种麻醉剂之间无差异。在切断阴部神经和 L5 以下所有脊神经根后,L2 腹根刺激诱发的逼尿肌压力被抑制,但未完全消除。在完整的神经膀胱中,传入和传出阴部神经活动在膀胱充盈时没有变化,但在去神经化膀胱中减少。在完整或去神经化膀胱中,在膀胱充盈期间都没有观察到传入活动的变化。
这些发现表明,更完整的去神经化膀胱模型应包括切断支配膀胱的腰骶脊神经根和阴部神经。这些改进的电神经图记录方法可能适合通过监测转移神经中的感觉活动来评估用于膀胱再神经支配的神经转移手术的有效性。