Frequency‐dependent inhibition of bladder function by saphenous nerve stimulation in anesthetized rats

Abstract

With notable changes in both the BCR and bladder capacity, our findings provide evidence of a novel bladder-inhibitory reflex in anesthetized rats that is mediated by the SAFN. Further work is needed to determine the clinical relevance of this neural pathway.

A pilot feasibility study of treating overactive bladder patients with percutaneous saphenous nerve stimulation

“…The rationale for inserting the needle electrode below the medial condyle of the tibia, rather than near the medial malleolus, was two‐fold. First, we sought to clinically translate pre‐clinical data obtained from anesthetized rats in which we discovered that SAFN stimulation (applied immediately below the knee) can evoke bladder‐inhibitory responses . Second, we wanted to attribute any potential therapeutic effects in this study to the selective electrial activation of the SAFN.…”

“…First, we sought to clinically translate pre-clinical data obtained from anesthetized rats in which we discovered that SAFN stimulation (applied immediately below the knee) can evoke bladderinhibitory responses. 12 Second, we wanted to attribute any potential therapeutic effects in this study to the selective electrial activation of the SAFN. We chose to target the needle insertion site below the medial tibial condyle because of the realtively superficial location of the primary SAFN branches, 8,18 which diverge distally into anterior and posterior branches.…”

“…In fact, the model showed that PTNS with an uninsulated needle can co‐activate multiple SAFN branches at stimulation amplitudes set equal to and even below the tibial nerve activation (ie, foot motor) threshold . In anesthetized rats, we also discovered that bladder‐inhibitory reponses can be evoked by electrically stimulating the SAFN trunk with a nerve cuff electrode implanted immediately below the knee . However, the clinical effects of SAFN stimulation (if any) on urinary function in humans has not yet been studied.…”

“…11 In anesthetized rats, we also discovered that bladder-inhibitory reponses can be evoked by electrically stimulating the SAFN trunk with a nerve cuff electrode implanted immediately below the knee. 12 However, the clinical effects of SAFN stimulation (if any) on urinary function in humans has not yet been studied.…”

Suppression of Urinary Voiding by Conditional High Frequency Stimulation of the Pelvic Nerve in Conscious Rats

“…In the clinical setting, sacral nerve stimulation is the procedure offered most commonly in cases that are refractory to current pharmacological and chemodenervation approaches, although other targets are also being used (see Janssen et al, 2017 for a recent review). In animal studies the net has been cast wider and there are several indications from studies in anesthetized cats and rats that stimulation of the tibial, saphenous, pudendal, dorsal penile, dorsal clitoral, and pelvic nerves all have the potential to modulate voiding ( Snellings and Grill, 2012 ; Su et al, 2012a , b ; Kovacevic and Yoo, 2014 ; Jen et al, 2016 ; Langdale et al, 2017 ; Moazzam and Yoo, 2017 ; Uy et al, 2017 ). In these studies, nerve stimulation was able to inhibit or reduce the frequency of voiding, or to decrease the rate of micturition-like contractions produced under isovolumetric conditions by producing an increase in bladder capacity.…”