Urinary Bladder Response to Unilateral Stimulation of Pelvic Nerves.

Ingersoll, Everett H.; Jones, Louise L.; Hegre, Erling S.

doi:10.3181/00379727-88-21488

Cited by 9 publications

(4 citation statements)

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“…The herein observed differences in the nature, degree, and distribution of cholinergic axonal degeneration (and regenerative axonal changes) between the var-ious walls of the decentralized bladder base supports the concept of bilateral (crossed) innervation of the bladder [Ingersoll et al, 1955;Carpenter and Rubin, 1967;ElmCr, 1975al in the cat. According to this concept, each side of the bladder is supplied predominantly by ipsilaterally derived nerves and to some extent also by nerves of contralateral origin across the midline plane of the organ.…”

Section: Vestibular Olfactory Trigeminal and Cervical-chain Sympathsupporting

confidence: 79%

Intrinsic neuromuscular defects in the neurogenic bladder. 1. Short‐term ultrastructural changes in muscular innervation of the decentralized feline bladder base following unilateral sacral ventral rhizotomy

Elbadawi

Atta

Franck

1984

Neurourology and Urodynamics

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The morphology of cholinergic and adrenergic muscular nerves of the feline bladder base was studied ultrastructurally 2, 3, and 4 weeks following its decentralization by unilateral sacral ventral rhizotomy. In all samples, there was widespread transsynaptic degeneration of cholinergic axon terminals and varicosities, with loss of neuroeffector junctions. This was associated with preservation of most adrenergic axons, and -especially in the 4-week samples-with concurrent early regeneration or sprouting in many cholinergic and adrenergic axons. The findings are discussed in relation to neural ultrastructure in other known models of axonal degeneration, and to the pathogenesis of neurogenic dysfunction of the parasympathetic-decentralized bladder. The concurrent degenerative and early regenerative axonal changes herein observed in such a bladder ( I ) suggest that the degeneration of cholinergic axons occurring shortly after rhizotomy is reversible, and probably is compensated for by developing adrenergic hyperinnervation; (2) support the existence of mutual peripheral cholinergic/adrenergic neurotrophism in the vesical muscularis; and (3) provide a probable structural basis for the altered motor and autonomic drug responses of the parasympathetic-decentralized bladder.Key words: neurogeuic bladder, parasympathetic-decentralized bladder, sacral ventral rhizotomy , transsynaptic axonal degeneration, cholinergicladrenerigc neurotrophism, adrenergic hyperinnervation INTRODUCTIONInterruption of efferent sacral parasympathetic neural pathways results in lowermotor-neuron dysfunction of the vesicourethral muscularis, associated with alteration of its neurogenic responses and autonomic drug sensitivity [ElmCr, 1973[ElmCr, , 1974[ElmCr, , 1975aSundin and Dahlstrom, 1973;Lapides, 1974;NorlCn, 1976 Ekstrom et al, 1978;Koyanagi, 1979; Ekstrom and ElmCr, 19801. This dysfunction has traditionally been attributed to loss of central cephalospinal control, according to the broad concept of micturition reflexes [Kuru, 1965; Mahony et al, 19771. Some recent experimental and clinical studies suggest, however, that motor dysfunction of the sacral-decentralized bladder may be due, largely, or in part, to changes in its intrinsic muscular innervation [Sundin and Dahlstrom, 1973; ElmCr, 1975, 1979; Norltn, 1976;Sundin et al, 1977; Dahlstrom, 19781. The present study was conducted to define the short-term ultrastructural changes in intrinsic cholinergic and adrenergic muscular innervation of the feline bladder base following unilateral sacral ventral rhizotomy. The findings will be discussed in the context of known neuroanatomical, neurophysiologic and neuropharmacologic principles in general, and neurogenic vesical dysfunction in particular. MATERIAL AND METHODSNine sexually mature male cats (10-12 months of age; 3-4.2 kg body weight) were used. Left sacral ventral rhizotomy was performed in all cats under intravenous pentobarbital anesthesia (30 mg/kg body weight). As recommended in earlier studies [Carlsson and Sundin, 1968; Sund...

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Section: Vestibular Olfactory Trigeminal and Cervical-chain Sympathsupporting

confidence: 79%

Intrinsic neuromuscular defects in the neurogenic bladder. 1. Short‐term ultrastructural changes in muscular innervation of the decentralized feline bladder base following unilateral sacral ventral rhizotomy

Elbadawi

Atta

Franck

1984

Neurourology and Urodynamics

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“…Therefore, spatial summation, resulting from simultaneous stimulation of both nerve roots of the same spinal segment is required for producing effective neuromodulation of bladder activity at low stimulation intensity. The requirement for this spatial summation could be associated with the bilateral innervation of the urinary bladder [21-23]. …”

Section: Discussionmentioning

confidence: 99%

Quantification of effectiveness of bilateral and unilateral neuromodulation in the rat bladder rhythmic contraction model

Nickles

Nelson

2013

BMC Urol

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BackgroundUsing the isovolumetric bladder rhythmic contraction (BRC) model in anesthetized rats, we have quantified the responsiveness to unilateral and bilateral stimulation of the L6 spinal nerve (SN) and characterized the relationship between stimulus intensity and inhibition of the bladder micturition reflex.MethodsA wire electrode was placed under either one or both of the L6 SN roots. A cannula was placed into the bladder via the urethra and the urethra was ligated. Saline infusion induced BRC.ResultsAt motor threshold (Tmot) intensity, SN stimulation of both roots (10 Hz) for 10 min reduced bladder contraction frequency from 0.63 ± 0.04 to 0.17 ± 0.09 contractions per min (26 ± 14% of baseline control; n = 10, p < 0.05). However, the same intensity of unilateral stimulation (n = 15) or sequential stimulation of both SNs (e.g. 5 min per side alternatively for a total of 10 min or 20 min) was less efficacious. The greater sensitivity to bilateral stimulation is not dependent upon precise bilateral timing of the stimulation pulses. Bilateral stimulation also produced both acute and prolonged- inhibition on bladder contractions in a stimulation intensity dependent fashion.ConclusionsUsing the bladder rhythmic contraction model, bilateral stimulation was more effective than unilateral stimulation of the SN. Clinical testing should be conducted to further compare efficacies of unilateral and bilateral stimulation. Bilateral stimulation may allow the use of lower stimulation intensities to achieve higher efficacy for neurostimulation therapies on urinary tract control.

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“…In accordance with the pattern of nerve distribution found in the present study, a functional convergence by the right and left pelvic nerve in normally innervated rat bladders has been estimated to 1 5 -2 o y~ (Carpenter & Rubin 1967, Elmer 1975). The pelvic nerve has been reported to be strictly or mainly confined to the ipsilateral bladder half in cats, dogs and rabbits (Gianuzzi 1863, Debaisieux 1912, Ingersoll et al 1955, 1957, Torbey & Leadbetter 1963, Diokno et al 1973.…”

Section: Discussionmentioning

confidence: 99%

Unilateral denervation of the rat urinary bladder and reinnervation: a predominance for ipsilateral changes

Ekström

Malmberg

Öberg

1986

Acta Physiologica Scandinavica

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Unilateral removal of the pelvic ganglion affected the bladder-half on the denervated side more profoundly than that on the non-denervated side. At an early stage (3-7 days) the former was heavier, had a lower choline acetyltransferase activity, developed less tension to nerve stimulation and, in course of time, became more sensitized to methacholine in vitro than the latter. At a late stage (30-60 days) the nerve-evoked contractile responses on the denervated side had increased, which was almost wholly attributed to the atropine-sensitive part of the contraction, but the recovery was not complete. On the non-denervated side the nerve-evoked responses were not significantly changed. It was calculated that in the normally innervated bladders 25-30% of the cholinergic nerves of each half were of contralateral origin. The figure was lower (18%) for the nerves mediating the atropine-resistant response.

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Urinary Bladder Response to Unilateral Stimulation of Pelvic Nerves.

Cited by 9 publications

References 1 publication

Intrinsic neuromuscular defects in the neurogenic bladder. 1. Short‐term ultrastructural changes in muscular innervation of the decentralized feline bladder base following unilateral sacral ventral rhizotomy

Intrinsic neuromuscular defects in the neurogenic bladder. 1. Short‐term ultrastructural changes in muscular innervation of the decentralized feline bladder base following unilateral sacral ventral rhizotomy

Quantification of effectiveness of bilateral and unilateral neuromodulation in the rat bladder rhythmic contraction model

Unilateral denervation of the rat urinary bladder and reinnervation: a predominance for ipsilateral changes

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