Chronic sacral nerve stimulation prevents detrusor structural and functional changes associated with bladder outlet obstruction—a rat model

Comiter, Craig V.; Mazar, Carla; Phull, Hardeep; Salkini, Mohamad

doi:10.1002/nau.20820

Cited by 17 publications

(16 citation statements)

References 23 publications

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“…In contrast to other rat models which tested the effect of S1 SN stimulation on the micturition reflex (11,23,25,39,40,43), we delivered electrical stimulation at the L6 level through which most mechanosensitive afferent fibers innervating the urinary bladder pass in the rat. SN stimulation inhibited the frequency of volumeinduced BRC, with the magnitude of the inhibition directly proportional to the applied current (stimulus intensity).…”

Section: Discussionmentioning

confidence: 99%

“…Chronic sacral nerve stimulation significantly eliminated nonvoiding contractions in a rat model of bladder outlet obstruction without changing bladder capacity (11). While these studies all demonstrated the ability of SN stimulation to inhibit elevated bladder activity, the electrical stimulation parameters were not optimized in each experimental study, and the parameters used varied, e.g., 80% motor threshold (T mot ) intensity at 20 Hz used by Wang et al (39), Wang and Hassouna (40), Zhou et al (43), and Shaker et al (25); 3-or 12-fold T mot intensity at 20 Hz by Riazimand and Mense (23) and 1 V at 16 Hz by Comiter et al (11). No study has been reported in which stimulation parameters for SN stimulation were optimized in an animal model evaluating bladder function.…”

mentioning

confidence: 93%

“…A stimulation frequency range (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) was tested at T mot intensity. A broader range (0.01-100 Hz) was tested at 0.6 mA (ϳ6 * T mot ).…”

mentioning

confidence: 99%

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Neuromodulation in a rat model of the bladder micturition reflex

Nickles

Nelson

2012

American Journal of Physiology-Renal Physiology

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A rat model of bladder reflex contraction (BRC) was used to determine the optimal frequency and intensity of spinal nerve (SN) stimulation to produce neuromodulation of bladder activity and to assess the therapeutic mechanisms of this neuromodulation. In anesthetized female rats (urethane 1.2 g/kg ip), a wire electrode was used to produce bilateral stimulation of the L6 SN. A cannula was placed into the bladder via the urethra, and the urethra was ligated to ensure an isovolumetric bladder. Saline infusion induced BRC. Electrical stimulation of the SN produced a frequency- and intensity-dependent attenuation of the frequency of bladder contractions. Ten-herz stimulation produced maximal inhibition; lower and higher stimulation frequency produced less attenuation of BRC. Attenuation of bladder contraction frequency was directly proportional to the current intensity. At 10 Hz, stimulation using motor threshold pulses (T(mot)) produced a delayed inhibition of the frequency of bladder contractions to 34 ± 11% of control. Maximal bladder inhibition appeared at 10 min poststimulation. High current intensity at 0.6 mA (∼6 * T(mot)) abolished bladder contraction during stimulation, and the inhibition was sustained for 10 min poststimulation (prolonged inhibition). Furthermore, in rats pretreated with capsaicin (125 mg/kg sc), stimulation produced a stronger inhibition of BRC. The inhibitory effects on bladder contraction may be mediated by both afferent and efferent mechanisms. Lower intensities of stimulation may activate large, fast-conducting fibers and actions through the afferent limb of the micturition reflex arc in SN neuromodulation. Higher intensities may additionally act through the efferent limb.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 93%

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Neuromodulation in a rat model of the bladder micturition reflex

Nickles

Nelson

2012

American Journal of Physiology-Renal Physiology

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“…The results of this study indicate that even in patients with chronic symptoms it is useful to perform a SNM test period since the chance of a successful outcome is comparable to those who have a short duration of complaints. Since successful outcome in our study was not related to the duration of complaints, we suggest that if structural changes occur over time in the untreated underactive and overactive bladder, it might be possible that SNM facilitates restoration of these changes or allows to compensate [10,17] . Also, the SNM effect occurs in a relatively short time (days), and therefore, it is unlikely that the chronic changes in the bladder resolve within days.…”

Section: Discussionmentioning

confidence: 65%

“…Also, studies show alterations in smooth muscle, which occur in an overactive bladder, may be a consequence of denervation of the detrusor which can contribute to DO [15,16] . Animal research shows that SNM prevents alterations of the bladder wall [17] . This indicates that SNM may be able to compensate for bladder wall changes.…”

Section: Pathophysiology Of Normentioning

confidence: 99%

The Impact of Duration of Complaints on Successful Outcome of Sacral Neuromodulation

Jairam

Drossaerts²,

Koeveringe³

et al. 2017

Urol Int

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Objectives: The study aimed to evaluate whether the duration of complaints in patients with overactive bladder syndrome or non-obstructive urinary retention predicts the outcome of sacral neuromodulation (SNM). Methods: All patients that underwent a SNM test period evaluation between 2011 and 2014, were included in this study. The duration of complaints was listed in 3 categories: (a) 0-5 years, (b) 5-10 years and (c) 10 years or longer. Analyses with chi square tests were performed to evaluate whether the duration of complaints are associated with outcome of SNM. Results: In total, 130 patients were included. Most patients had a complaint duration of 0-5 years (n = 60). The test period was successful in 56% (n = 74) of the total group. Analyses showed that the duration of complaints is not significantly associated with outcome of SNM (p = 0.752), even when subdivided per indication, and also when possible confounders such as age at test and indication are taken into account (p = 0.720). Conclusion: Based on the results of this study, there is no relationship between duration of complaints and SNM outcome. SNM seems to remain a feasible treatment option, despite of possible anatomical or physiological changes within the lower urinary tract.

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What was hot at the joint ICS and IUGA meeting Toronto, Canada, 23–27 August 2010

Mangera

Cartwright

Tikkinen

et al. 2010

Neurourology and Urodynamics

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Chronic sacral nerve stimulation prevents detrusor structural and functional changes associated with bladder outlet obstruction—a rat model

Abstract: Partial BOO caused functional and structural changes in the rat bladder. SNS in obstructed rats prevents these alterations, without adversely affecting detrusor contractility.

Cited by 17 publications

References 23 publications

Neuromodulation in a rat model of the bladder micturition reflex

Neuromodulation in a rat model of the bladder micturition reflex

The Impact of Duration of Complaints on Successful Outcome of Sacral Neuromodulation

What was hot at the joint ICS and IUGA meeting Toronto, Canada, 23–27 August 2010

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