Bladder and Urethral Responses to Pelvic Nerve Stimulation in the Pig

Dalmose, A. L.; Rijkhoff, Nico; Andersen, I. S.; Stefania, D.; Jørgensen, Troels Munch; Djurhuus, Jens Christian

doi:10.1080/003655902320765944

Cited by 17 publications

(14 citation statements)

References 48 publications

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“…We observed voiding during stimulation in the conscious animal at this site in two of four animals. Both bilateral stimulation and sites near the bladder neck or base of the bladder have been cited as important locations for bladder stimulation [4][5][11][12][23][24]. However, potential concerns arise over stimulation at the bladder neck or base of the bladder in humans.…”

Section: Discussionmentioning

confidence: 99%

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Bladder-wall and pelvic-plexus stimulation with model microstimulators: Preliminary observations

Walter¹,

FitzGerald²,

Wheeler³

et al. 2004

JRRD

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Severe urinary retention is not a common condition, but may occur following some pelvic surgeries or other medical conditions. Electrical stimulation of the bladder has been examined as a means of managing this difficult problem. We conducted preliminary investigations in cats to prove the hypothesis that pelvic-plexus (bladder-neck) stimulation would produce greater micturition response with reduced side effects, such as animal movement or discomfort, than bladder-wall stimulation with electrodes implanted higher on the bladder wall. We used model microstimulators that mimic the look and function of commercial microstimulators, but that we constructed. We instrumented four female cats during a survival surgery. Animals recovered well and studies were conducted over a 1-month period in the conscious animal and under anesthesia. We performed a variety of studies with different stimulation parameters and electrode locations to evaluate our hypothesis. In the active animal, we supplied only low currents, but two animals responded to stimulation with bladder contractions and voiding. Following anesthesia, higher stimulating currents resulted in greater bladder contractions during stimulation in two of the three animals. In two cases, pelvic-plexus (bladder-neck) stimulation induced greater micturition responses than direct bladderwall stimulation. In conclusion, we learned from these preliminary observations that stimulation at the pelvic plexus (bladder neck) may induce a better micturition response than stimulation higher on the bladder-wall. Newly available commercial microstimulators should be further studied for the treatment of urinary retention.

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Section: Discussionmentioning

confidence: 99%

“…We performed these studies both before and after SCI in the active animal. Other reports of end-organ stimulation exist [12]. A recent study has cited the benefit of stimulation of the bladder wall with electrodes on the end of a urethral catheter in the bladder in children [13].…”

Section: Introductionmentioning

confidence: 98%

Bladder-wall and pelvic-plexus stimulation with model microstimulators: Preliminary observations

Walter¹,

FitzGerald²,

Wheeler³

et al. 2004

JRRD

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show abstract

“…Thus, we conclude that the use of swine should be limited for direct bladder stimulation studies, and we plan to use the dog model in the future. Peak bladder pressures of 30 cm H 2 0 or greater, however, were reported in two experimental studies using electrical stimulation in female minipigs or swine of similar size, suggesting that other deficiencies may be present with our protocol [24,25]. There methods of stimulating pelvic plexus nerves close to the spinal cord, cuff electrodes and 10 s stimulation periods may have been superior to our direct bladder wall stimulation methods.…”

Section: Problem With the Animal Modelmentioning

confidence: 71%

“…If spontaneous bladder contractions had been present we would expect inhibition of the urethral sphincter contractions in the presence of elevated bladder pressures. Other studies of swine and minipigs have not observed increases in urethral pressures during elevated bladder pressures; bladder squeeze tests in these other studies, however, were not conducted [24,25].…”

Section: Side Effects Of Stimulationmentioning

confidence: 99%

Evaluation of Bipolar Permaloc™ Electrodes for Direct Bladder Stimulation

Walter¹,

Allen²,

Sayers³

et al. 2012

TOREHJ

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Abstract:Purpose: A bladder control system for spinal cord injured (SCI) patients is needed that can be implanted with minimally invasive methods. New Permaloc bipolar electrodes consisting of 6 mm helical, wire, stimulating surfaces separated by 3 mm and a polypropylene securing barb (Synapse Biomedical Inc) were developed for this application. They are implanted on the bladder wall with a 16 gauge needle, a minimally invasive method.Methods: Seven swines were anesthetized, the lower urinary tract exposed and instrumented with pressure transducers. Four Permaloc TM electrodes were implanted following identification of effective bladder wall stimulation sites next to the ureters and dorsal neurovascular bundle. Bladder stimulation to induce high pressures was conducted at 40 Hz, 400 s pulses, 5 s stimulation periods and a high stimulating current of 40 mA.Results: At the high stimulating current peak bladder pressures were low, ranging from 12±2 to15±3 cm H 2 0, insufficient to induce urination. Urethral sphincter contractions occurred during high bladder pressure. A spinal reflex role for high sphincter pressures during stimulation was shown by similar high pressures recorded during a bladder squeeze test without stimulation. Conclusions:Stimulation with Permaloc TM bipolar electrodes at high currents produced insufficient bladder pressures for urination. Further modifications of the electrode such as greater separation of the bipolar stimulating surfaces or changes in the testing methods such as alternative animal models are needed to induce high bladder pressures without side effects.

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“…As a result, new questions have opened a large field for fundamental research. Many studies involve electrical interfaces with peripheral nerves to produce controlled electrical activation (DALMOSE et al, 2002;DEDEURWAERDERE et al, 2004;LOPEZ-GUAJARDO et al, 2001;VERAART et al, 1993) or to monitor nerve fibre activity (INMANN and HAUGLAND, 2004;JEZERNIK et al, 2000;RIGGER et al, 2004).…”

Section: Introductionmentioning

confidence: 97%

Two-way communication for programming and measurement in a miniature implantable stimulator

Thil

Gérard

Jarvis

et al. 2005

Med. Biol. Eng. Comput.

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Implantable stimulators are needed for chronic electrical stimulation of nerves and muscles in experimental studies. The device described exploits the versatility of current microcontrollers for stimulation and communication in a miniature implant. Their standard outputs can provide the required selectable constant-current sources. In this device, pre-programmed stimulation paradigms were selected by transcutaneous light pulses. The potential of a programmable integrated circuit (PIC) was thus exploited. Implantable devices must be biocompatible. A novel encapsulation method that require no specialised equipment and that used two classical encapsulants, silicone and Teflon was developed. It was tested for implantation periods of up to four weeks. A novel way to estimate electrode impedance in awake animals is also presented. It was thus possible to follow the evolution of the nerve-electrode interface and, if necessary, to adjust the stimulation parameters. In practice, the electrode voltage at the end of a known constant-current pulse was measured by the PIC. The binary coded value was then indicated to the user as a series of muscle twitches that represented the binary value of the impedance measurement. This neurostimulator has been successfully tested in vitro and in vivo. Thresholds and impedance values were chronically monitored following implantation of a self-sizing spiral cuff electrode. Impedance variations in the first weeks could reflect morphological changes usually observed after the implantation of such electrodes.

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Bladder and Urethral Responses to Pelvic Nerve Stimulation in the Pig

Cited by 17 publications

References 48 publications

Bladder-wall and pelvic-plexus stimulation with model microstimulators: Preliminary observations

Bladder-wall and pelvic-plexus stimulation with model microstimulators: Preliminary observations

Evaluation of Bipolar Permaloc™ Electrodes for Direct Bladder Stimulation

Two-way communication for programming and measurement in a miniature implantable stimulator

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