Electrical stimulation of the urethra evokes bladder contractions and emptying in spinal cord injury men: Case studies

Kennelly, Michael; Bennett, Maria E.; Grill, Warren M.; Grill, Julie H.; Boggs, Joseph W.

doi:10.1179/2045772311y.0000000012

“…Stimulation of flow-sensing urethral afferents by intraurethral saline infusion enhances volume-induced reflex bladder contractions in rats (294). Electrical stimulation of urethral afferents also evokes reflex bladder contractions in the cat (325, 326, 420). …”

Section: Peripheral Nervous Systemmentioning

confidence: 99%

Neural Control of the Lower Urinary Tract

Groat

¹

,

Griffiths

²

,

Yoshimura

³

2014

Comprehensive Physiology

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This article summarizes anatomical, neurophysiological, pharmacological, and brain imaging studies in humans and animals that have provided insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract. The functions of the lower urinary tract to store and periodically eliminate urine are regulated by a complex neural control system in the brain, spinal cord, and peripheral autonomic ganglia that coordinates the activity of smooth and striated muscles of the bladder and urethral outlet. The neural control of micturition is organized as a hierarchical system in which spinal storage mechanisms are in turn regulated by circuitry in the rostral brain stem that initiates reflex voiding. Input from the forebrain triggers voluntary voiding by modulating the brain stem circuitry. Many neural circuits controlling the lower urinary tract exhibit switch-like patterns of activity that turn on and off in an all-or-none manner. The major component of the micturition switching circuit is a spinobulbospinal parasympathetic reflex pathway that has essential connections in the periaqueductal gray and pontine micturition center. A computer model of this circuit that mimics the switching functions of the bladder and urethra at the onset of micturition is described. Micturition occurs involuntarily in infants and young children until the age of 3 to 5 years, after which it is regulated voluntarily. Diseases or injuries of the nervous system in adults can cause the re-emergence of involuntary micturition, leading to urinary incontinence. Neuroplasticity underlying these developmental and pathological changes in voiding function is discussed.

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“…Studies in cats have established that specific stimulation patterns may be optimal for selection of the pudendal-mediated continence and micturition reflexes. 83,85,86 Studies in humans, with intraurethral 87 and percutaneous pudendal 88 stimulation approaches support the potential for this approach. As the pudendal nerve provides somatic control of the sphincter, selective stimulation of the desired pudendal afferent pathways 89 or HF nerve block of the sphincter 90 are critical to the success of this approach.…”

Section: Bladder Neuroprosthesesmentioning

confidence: 94%

Neuroprosthetic technology for individuals with spinal cord injury

Collinger¹,

Foldes

²

,

Bruns

³

et al. 2013

The Journal of Spinal Cord Medicine

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Context: Spinal cord injury (SCI) results in a loss of function and sensation below the level of the lesion. Neuroprosthetic technology has been developed to help restore motor and autonomic functions as well as to provide sensory feedback. Findings: This paper provides an overview of neuroprosthetic technology that aims to address the priorities for functional restoration as defined by individuals with SCI. We describe neuroprostheses that are in various stages of preclinical development, clinical testing, and commercialization including functional electrical stimulators, epidural and intraspinal microstimulation, bladder neuroprosthesis, and cortical stimulation for restoring sensation. We also discuss neural recording technologies that may provide command or feedback signals for neuroprosthetic devices. Conclusion/clinical relevance: Neuroprostheses have begun to address the priorities of individuals with SCI, although there remains room for improvement. In addition to continued technological improvements, closing the loop between the technology and the user may help provide intuitive device control with high levels of performance.

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“…Stimulation of flow-sensing urethral afferents by intraurethral saline infusion enhances volume-induced reflex bladder contractions in rats (294). Electrical stimulation of urethral afferents also evokes reflex bladder contractions in the cat (325,326,420).…”

Section: Afferent Innervationmentioning

confidence: 97%

Neural Control of the Lower Urinary Tract

2009

Encyclopedia of Neuroscience

0

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This article summarizes anatomical, neurophysiological, pharmacological, and brain imaging studies in humans and animals that have provided insights into the neural circuitry and neurotransmitter mechanisms controlling the lower urinary tract. The functions of the lower urinary tract to store and periodically eliminate urine are regulated by a complex neural control system in the brain, spinal cord, and peripheral autonomic ganglia that coordinates the activity of smooth and striated muscles of the bladder and urethral outlet. The neural control of micturition is organized as a hierarchical system in which spinal storage mechanisms are in turn regulated by circuitry in the rostral brain stem that initiates reflex voiding. Input from the forebrain triggers voluntary voiding by modulating the brain stem circuitry. Many neural circuits controlling the lower urinary tract exhibit switch-like patterns of activity that turn on and off in an all-or-none manner. The major component of the micturition switching circuit is a spinobulbospinal parasympathetic reflex pathway that has essential connections in the periaqueductal gray and pontine micturition center. A computer model of this circuit that mimics the switching functions of the bladder and urethra at the onset of micturition is described. Micturition occurs involuntarily in infants and young children until the age of 3 to 5 years, after which it is regulated voluntarily. Diseases or injuries of the nervous system in adults can cause the re-emergence of involuntary micturition, leading to urinary incontinence. Neuroplasticity underlying these developmental and pathological changes in voiding function is discussed.

show abstract

Electrical stimulation of the urethra evokes bladder contractions and emptying in spinal cord injury men: Case studies

Cited by 21 publications

References 34 publications

Neural Control of the Lower Urinary Tract

Neural Control of the Lower Urinary Tract

Neuroprosthetic technology for individuals with spinal cord injury

Neural Control of the Lower Urinary Tract

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