Bladder emptying by intermittent electrical stimulation of the pudendal nerve.

Published

Journal Article

Persons with a suprasacral spinal cord injury cannot empty their bladder voluntarily. Bladder emptying can be restored by intermittent electrical stimulation of the sacral nerve roots (SR) to cause bladder contraction. However, this therapy requires sensory nerve transection to prevent dyssynergic contraction of the external urethral sphincter (EUS). Stimulation of the compound pudendal nerve trunk (PN) activates spinal micturition circuitry, leading to a reflex bladder contraction without a reflex EUS contraction. The present study determined if PN stimulation could produce bladder emptying without nerve transection in cats anesthetized with alpha-chloralose. With all nerves intact, intermittent PN stimulation emptied the bladder (64 +/- 14% of initial volume, n = 37 across six cats) more effectively than either distention-evoked micturition (40 +/- 19%, p < 0.001, n = 27 across six cats) or bilateral intermittent SR stimulation (25 +/- 23%, p < 0.005, n = 4 across two cats). After bilateral transection of the nerves innervating the urethral sphincter, intermittent SR stimulation voided 79 +/- 17% (n = 12 across three cats), comparable to clinical results obtained with SR stimulation. Voiding via intermittent PN stimulation did not increase after neurotomy (p > 0.10), indicating that PN stimulation was not limited by bladder-sphincter dyssynergia. Intermittent PN stimulation holds promise for restoring bladder emptying following spinal injury without requiring nerve transection.

Full Text

Duke Authors

Cited Authors

  • Boggs, JW; Wenzel, BJ; Gustafson, KJ; Grill, WM

Published Date

  • March 2006

Published In

Volume / Issue

  • 3 / 1

Start / End Page

  • 43 - 51

PubMed ID

  • 16510941

Pubmed Central ID

  • 16510941

Electronic International Standard Serial Number (EISSN)

  • 1741-2552

International Standard Serial Number (ISSN)

  • 1741-2560

Digital Object Identifier (DOI)

  • 10.1088/1741-2560/3/1/005

Language

  • eng