A Decade of Experience with Electronic Simulation of the Micturition Reflex

Bradley, William E.; Timm, Gerald W.; Chou, Shelley N.

doi:10.1159/000279737

Cited by 56 publications

(16 citation statements)

References 44 publications

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“…Real interest in the electrical control of bladder function began in the 1950s with the studies of McGuire (9) and was followed in the 1960s by many publications dealing with attempts to initiate micturition through implantable electrodes. Most of these reports dealt with the stimulation of either the spinal cord (10)(11)(12)(13)(14)(15) or of the detrusor directly (10,14,(16)(17)(18), while a few discussed the use of the pelvic (6,10,18) or sacral nerves (19)(20)(21)(22) as a means to stimulate the bladder.…”

Section: Historical Backgroundmentioning

confidence: 99%

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Feasibility of Controlled Micturition through Electric Stimulation

Schmidt

Tanagho²

1979

Urol Int

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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 are presented. 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.

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Section: Historical Backgroundmentioning

confidence: 99%

“…Despite some 20 years of active interest in this particular endeavor, few instances of true long-term success have been documented (10). The best results thus far have been with direct stimulation of the lower motor neuron bladder.…”

Section: Historical Backgroundmentioning

confidence: 99%

Feasibility of Controlled Micturition through Electric Stimulation

Schmidt

Tanagho²

1979

Urol Int

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“…Experimental work using SNS for functional disturbances of micturition began in the 1950s, with stimulation of the spinal cord, the detrusor muscle and the striated sphincter used to try and provoke controlled micturition [14, 15, 16, 17]. The first clinical application of these principles was an SNS implant performed in 1981 by Tanagho and Schmidt [18].…”

Section: Evolution Of the Proceduresmentioning

confidence: 99%

Sacral Nerve Stimulation for Faecal Incontinence

Pillinger¹,

Gardiner²,

Duthie³

2005

Dig Surg

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Faecal incontinence is a common problem. Conservative measures are effective in a significant proportion of patients. Failure of conservative management has until recently meant recourse to surgical intervention. Surgical treatment is often associated with disappointing results. Recently, sacral nerve stimulation (SNS) has been developed as a minimally invasive, effective technique for idiopathic and acquired faecal incontinence. The technique uses chronic low-level electrical stimulation of the sacral nerves, or neuromodulation, to produce a clinically beneficial effect on the distal colon and rectum, the pelvic floor and the anal sphincter complex. SNS is a 2-stage procedure: a diagnostic stage – temporary percutaneous nerve evaluation (PNE), and a therapeutic stage – permanent SNS. The predictive value of PNE is high, and the surgical trauma and morbidity of both procedures extremely low. The technique has been adapted from its original application in urinary dysfunction. It is almost impossible to produce level 1 evidence for this type of intervention; however, the results are superior to other interventions. Patient selection criteria are evolving, but there is a growing body of evidence that supports its use as first-line treatment for faecal incontinence in patients where conservative measures have failed.

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“…Different modalities to apply electrical current to the lower urinary tract are available. Surface electrodes can be used as nonimplantable devices [2]. Insertable plugs in the anal canal or the vagina are applied to treat incontinence [3, 4, 5].…”

Section: Introductionmentioning

confidence: 99%

The Role of Electrical Stimulation in Voiding Dysfunction

Kerrebroeck

1998

Eur Urol

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A Decade of Experience with Electronic Simulation of the Micturition Reflex

Cited by 56 publications

References 44 publications

Feasibility of Controlled Micturition through Electric Stimulation

Feasibility of Controlled Micturition through Electric Stimulation

Sacral Nerve Stimulation for Faecal Incontinence

The Role of Electrical Stimulation in Voiding Dysfunction

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