282 NERVE ROOT SELECTIVITY OF SPINAL NERVE STIMULATION FOR MICTURITION CONTROL (2013)

You have accessJournal of UrologyBladder and Urethra: Anatomy, Physiology and Pharmacology (I)1 Apr 2013282 NERVE ROOT SELECTIVITY OF SPINAL NERVE STIMULATION FOR MICTURITION CONTROL Xin Su, Julie Hill, Cary DeWitte, Dwight Nelson, and Timothy Ness Xin SuXin Su Minneapolis, MN More articles by this author , Julie HillJulie Hill Birmingham, AL More articles by this author , Cary DeWitteCary DeWitte Birmingham, AL More articles by this author , Dwight NelsonDwight Nelson Minneapolis, MN More articles by this author , and Timothy NessTimothy Ness Birmingham, AL More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.1666AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Sensory information from the urinary bladder is conveyed via two sets of functionally distinct spinal nerves to the spinal cord, including lumbar splanchnic nerves (T13/L1) and sacral pelvic nerves (L6/S1). It is unknown whether stimulation of the two nerves could modify urinary micturition reflexes differently and potentially prove useful as distinct treatment options for patients with urgency and retention. We have compared the effects of T13 or L6 spinal nerve stimulation on bladder micturition reflex responses in the rat. METHODS Female rats were anesthetized (urethane, 1.2 g/Kg, s.c.) and a cannula was placed into the bladder via the bladder dome for saline infusion and intravesical pressure monitoring. Two teflon-coated stainless steel electrodes were placed bilaterally under each of the T13 or L6 spinal nerve and biphasic pulses of current stimulation were delivered independently using two Grass stimulators. Saline was infused at a rate of 0.05 μl/min. Inter-Contraction Interval (ICI), Micturition Threshold Pressure (TP) and Voided Volume (VV) were evaluated. RESULTS Electrical stimulation (100 μsec, 10 Hz, 10 min duration) at 3 × motor threshold (Tmot; the minimal current needed to evoke observable skeletal muscle contractions) produced statistically significant effects on micturition reflexes. The responses to stimulation at the two different sites were opposite in direction. At the L6 nerve root, a statistically significant lengthening of ICI and increase of the TP (n=7, p<0.01, paired t-test) was observed. At the T13 nerve root, the identical stimulation induced a significant shortening of ICI and increase of the TP (n=5, p<0.05, paired t-test, Figure). CONCLUSIONS T13 and L6 electrical stimulation induced opposing effects on cystometric measures in the rat. These results suggest a potential therapeutic role for lumbar splanchnic (T13) stimulation for reducing hyporesponsiveness of the urinary bladder (e.g. as a potential therapy for urinary retention) while sacral pelvic nerve stimulation (L6) may prove to be a better therapeutic target for reducing bladder hypersensitivity (e.g. as a therapy for urinary urgency). These preclinical results should be followed up with using clinical assessments and testing. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e115 Peer Review Report Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Xin Su Minneapolis, MN More articles by this author Julie Hill Birmingham, AL More articles by this author Cary DeWitte Birmingham, AL More articles by this author Dwight Nelson Minneapolis, MN More articles by this author Timothy Ness Birmingham, AL More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...