The Component Reflexes of Micturition in the Cat. Part Iii

Barrington, F. J. F.

doi:10.1093/brain/64.4.239

Cited by 125 publications

(69 citation statements)

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“…This is consistent with an important role for pudendal urethral afferents activating the augmenting reflex to produce efficient voiding in cats (Barrington 1931(Barrington , 1941 and rats (Peng et al 2008). There is also evidence suggesting that the augmenting reflex operates in humans.…”

Section: Discussionsupporting

confidence: 78%

Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents

et al. 2008

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Urinary retention is the inability to empty the bladder completely, and may result from bladder hypocontractility, increases in outlet resistance, or both. Chronic urinary retention can lead to several urological complications and is often refractory to pharmacologic, behavioral, and surgical treatments. We sought to determine whether electrical stimulation of sensory fibers in the pudendal nerve could engage an augmenting reflex and thereby improve bladder emptying in an animal model of urinary retention. We measured the efficiency of bladder emptying with and without concomitant electrical stimulation of pudendal nerve afferents in urethane anesthetized rats. Voiding efficiency (VE=voided volume/initial volume) was reduced from 72±7% to 29±7% following unilateral transection of the sensory branch of the pudendal nerve (UST) and from 70±5% to 18±4% following bilateral transection (BST). Unilateral electrical stimulation of the proximal transected sensory pudendal nerve during distention-evoked voiding contractions significantly improved VE. Low intensity stimulation at frequencies of 1-50 Hz increased VE to 40-51% following UST and to 39-49% following BST, while high intensity stimulation was ineffective at increasing VE. The increase in VE was mediated by increases in the duration of distention-evoked voiding bladder contractions, rather than increases in contraction amplitude. These results are consistent with an essential role for pudendal sensory feedback in efficient bladder emptying, and raise the possibility that electrical activation of pudendal nerve afferents may provide a new approach to restore efficient bladder emptying in persons with urinary retention.

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Section: Discussionsupporting

confidence: 78%

Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents

et al. 2008

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“…Voiding via stimulation of the DNP was achieved with continuous stimulation and without transection of any nerves via reflex activation of parasympathetic pelvic efferents (2,3). The stimulationevoked voiding efficiencies are comparable with voiding percentages reported from stimulation of perineal afferents of the pudendal nerve (63% Ϯ 20%) and the compound pudendal nerve (64% Ϯ 14%) in the ␣-chloralose anesthetized male cat (5,6).…”

Section: Discussionmentioning

confidence: 53%

“…These results demonstrate a clear role of genital afferents in modulating the micturition reflex and suggest the DNP as a potential target for functional restoration of bladder control using electrical stimulation. electrical stimulation; spinal cord injury; dorsal nerve of the penis; frequency dependence RECIPROCAL COORDINATION of the urinary bladder and the external urethral sphincter (EUS) to maintain continence and produce micturition is controlled by the pontine micturition center (2,3,24). The spinobulbospinal micturition reflex is also subject to modulation by peripheral afferent activity (29,30) that can influence voiding efficiency (41).…”

mentioning

confidence: 99%

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Activation and inhibition of the micturition reflex by penile afferents in the cat

Woock

Yoo²,

Grill³

2008

American Journal of Physiology-Regulatory, Integrative and Comp

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Woock JP, Yoo PB, Grill WM. Activation and inhibition of the micturition reflex by penile afferents in the cat. Am J Physiol Regul Integr Comp Physiol 294: R1880-R1889, 2008. First published April 23, 2008 doi:10.1152/ajpregu.00029.2008.-Coordination of the urinary bladder and the external urethral sphincter is controlled by descending projections from the pons and is also subject to modulation by segmental afferents. We quantified the effects on the micturition reflex of sensory inputs from genital afferents traveling in the penile component of the somatic pudendal nerve by electrical stimulation of the dorsal nerve of the penis (DNP) in ␣-chloralose anesthetized male cats. Depending on the frequency of stimulation (range, 1-40 Hz), activation of penile afferents either inhibited contractions of the bladder and promoted urine storage or activated the bladder and produced micturition. Stimulation of the DNP at 5-10 Hz inhibited distension-evoked contractions and increased the maximum bladder capacity before incontinence. Conversely, stimulation at 33 and 40 Hz augmented distension-evoked contractions. When the bladder was filled above a threshold volume (70% of the volume necessary for distension-evoked contractions), stimulation at 20 -40 Hz activated de novo the micturition reflex and elicited detrusor contractions that increased voiding efficiency compared with distension-evoked voiding. Electrical stimulation of the DNP with a cuff electrode or percutaneous wire electrode produced similar results. The ability to evoke detrusor contractions by activation of the DNP was preserved following acute spinal cord transection. These results demonstrate a clear role of genital afferents in modulating the micturition reflex and suggest the DNP as a potential target for functional restoration of bladder control using electrical stimulation. electrical stimulation; spinal cord injury; dorsal nerve of the penis; frequency dependence RECIPROCAL COORDINATION of the urinary bladder and the external urethral sphincter (EUS) to maintain continence and produce micturition is controlled by the pontine micturition center (2, 3, 24). The spinobulbospinal micturition reflex is also subject to modulation by peripheral afferent activity (29, 30) that can influence voiding efficiency (41). The objective of the present study was to quantify the effects of genital afferents traveling in the penile component of the somatic pudendal nerve on the micturition reflex in the cat.Activation of pudendal afferent nerve fibers can engage spinal (5) and spinobulbospinal (2, 3) reflexes that are integral to the regulation of bladder function. Fluid flow through the urethra activates pudendal afferents (56), and this flow-driven activation can elicit detrusor contractions and facilitate micturition (2, 44, 48). Furthermore, electrical stimulation of pudendal urethral afferents in the cat (5, 49) and human (21) elicits detrusor contraction, and these responses are preserved following decerebration and acute and chronic spinal cord transection (SCT;...

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“…Activation of receptors in the urethra via turbulent fluid flow generates activity in urethral afferents, 13,14 which mediates a spinal cord reflex (Barrington's 'augmenting reflex') that coordinates the bladder contraction and sphincter relaxation necessary to produce micturition. 15,16 Likewise, electrical stimulation of urethral afferents leads to activation of the bladder and inhibition of urethral sphincter activity 5,17 before and after spinalization 6 and can produce bladder emptying in cats. [7][8][9][10][11]18 Analysis of the bladder and sphincter responses across a range of stimulus parameters 12 indi-bladder efficiently and reduce post-void residual volume to a minimum in both the acute 8,18 and chronic SCI animal model.…”

Section: Introductionmentioning

confidence: 99%

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

Kennelly¹,

Bennett²,

Grill

et al. 2011

The Journal of Spinal Cord Medicine

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Objective: Electrical stimulation of the urethra can evoke bladder contractions in persons with spinal cord injury (SCI). The objective of this study was to determine whether electrical stimulation of the urethra could evoke bladder contractions that empty the bladder. Methods: The first patient was a 45-year-old man with a T6 ASIA A SCI secondary to a gunshot wound 15 years prior. The second patient was a 51-year-old man with a T2 ASIA A SCI secondary to a fall from scaffolding 2 years prior. Both patients demonstrated neurogenic detrusor overactivity on urodynamics and managed their bladder with clean intermittent catheterization and oxybutynin medication. Following informed consent, each patient discontinued oxybutynin 2 days prior to urodynamic testing. Urodynamics were performed with a custom 12 French balloon catheter mounted with ring-shaped electrodes (3 mm) positioned in the prostatic urethra. After filling the bladder to approximately three-fourth of capacity at a rate of 25 ml/minute, the urethra was stimulated with a range of parameters to determine whether electrical stimulation could evoke a bladder contraction and empty the bladder. Results: Electrical stimulation of the prostatic urethra evoked bladder contractions (peak detrusor pressures of 60-80 cm H 2 O) that emptied the bladder in both subjects. In the first subject, stimulation (9-12 mA, 20 Hz) emptied 64-75%, leaving post-void residual volumes (PVRs) of 41-20 ml. In the second subject, stimulation (20 mA, 20 Hz) emptied 68-77%, leaving PVRs of 56-45 ml. Conclusion: Urethral stimulation evoked bladder emptying in persons with SCI.

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The Component Reflexes of Micturition in the Cat. Part Iii

Cited by 125 publications

References 0 publications

Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents

Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents

Activation and inhibition of the micturition reflex by penile afferents in the cat

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

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