Schmidt R A, Tanagho E A
Urol Int. 1979;34(3):199-230. doi: 10.1159/000280267.
Historically, man has been aware of bioelectric phenomena for some 4,000 years. Yet it has only been during the last 20 years that technology has advanced to the stage where controlled bladder emptying has become feasible. A great deal of interest followed the introduction of transistor and bladder stimulation via the principle of radio frequency induction. Spinal cord, sacral, and pelvic nerve and direct bladder stimulation have all been attempted. Only direct bladder stimulation in lower motor neuron situations has shown any promise. The many difficulties associated with bladder stimulation include simultaneous sphincter contraction, pain, electrode and insulation difficulties, and fibroplasia due to movement of electrodes placed in pliable tissues. In addition, the role of the prostate, increased urethral length, and erection responses in the male have received little investigation. These problems are outlined and experimental observations of attempts to achieve controlled micturition in canines areresented. These studies were carried out over a 3-year period, and emphasize responses to stimulation of the spinal cord and sacral roots. It was concluded that the most efficient manner by which to effect simulated micturition is via stimulation of the ventral sacral root dominant for bladder responsiveness, and combine this with selective division of somatic fibers of only the root being stimulated.
从历史上看，人类认识生物电现象已有约4000年。然而，直到最近20年，技术才发展到可控膀胱排空变得可行的阶段。随着晶体管的引入以及通过射频感应原理进行膀胱刺激，引发了人们极大的兴趣。脊髓、骶神经、盆腔神经以及直接膀胱刺激都曾被尝试过。只有在下运动神经元情况下的直接膀胱刺激显示出了一定前景。与膀胱刺激相关的诸多困难包括括约肌同时收缩、疼痛、电极及绝缘问题，以及置于柔软组织中的电极移动导致的纤维增生。此外，前列腺的作用、男性尿道长度增加以及勃起反应很少受到研究。本文概述了这些问题，并展示了在犬类中实现可控排尿尝试的实验观察结果。这些研究历时3年，着重研究了对脊髓和骶神经根刺激的反应。研究得出结论，实现模拟排尿的最有效方式是刺激对膀胱反应占主导的骶前根，并将其与仅对受刺激神经根的躯体纤维进行选择性切断相结合。
