Hübner W A, Trigo-Rocha F, Schmidt R A, Tanagho E A
Department of Urology, University of California School of Medicine, San Francisco.
J Urol. 1993 Mar;149(3):624-6. doi: 10.1016/s0022-5347(17)36167-0.
The minimal invasiveness of laparoscopy prompted us to investigate its use for placement of electrodes for stimulation of the hypogastric nerve and the vas deferens. In an acute canine model, pressure changes in the vas deferens secondary to electrostimulation were recorded. The laparoscopic approach included four ports. Monopolar cuff electrodes were placed around the hypogastric nerve and the vas deferens, and the leads of both were pulled through the abdominal wall. After multiple percutaneous stimulations (20 mAmp., 20 Hz. and 200 microsecond pulse width), the abdomen was opened through a midline incision to check the position of the electrodes. Electrostimulation was repeated with the abdomen open. Electrostimulation of both the hypogastric nerve and vas deferens resulted in marked pressure rises in the vas. These increases were similar in response to both surface and percutaneous stimulation. We thus believe that laparoscopic implantation of electrodes followed by percutaneous preliminary stimulation of the superior hypogastric plexus or the vas deferens may be a viable future approach to anejaculation.
腹腔镜手术的微创性促使我们研究其在放置电极以刺激腹下神经和输精管方面的应用。在急性犬模型中,记录了电刺激后输精管的压力变化。腹腔镜手术入路包括四个端口。将单极袖套电极放置在腹下神经和输精管周围,并将两者的导线经腹壁引出。在多次经皮刺激(20毫安、20赫兹和200微秒脉冲宽度)后,经中线切口打开腹部以检查电极位置。在腹部开放的情况下重复电刺激。对腹下神经和输精管的电刺激均导致输精管内压力显著升高。这些升高对表面刺激和经皮刺激的反应相似。因此,我们认为腹腔镜植入电极,随后经皮初步刺激上腹下丛或输精管,可能是未来治疗射精障碍的一种可行方法。