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

Publication ,  Journal Article
Peng, CW; Chen, JJJ; Cheng, CL; Grill, WM
Published in: Journal Of Neural Engineering
June 2008

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.

Duke Scholars

Published In

Journal Of Neural Engineering

ISSN

1741-2560

Publication Date

June 2008

Volume

5

Issue

2

Start / End Page

144 / 154

Related Subject Headings

  • Urination
  • Urinary Retention
  • Urinary Bladder
  • Treatment Outcome
  • Rats, Sprague-Dawley
  • Rats
  • Muscle, Smooth
  • Muscle Contraction
  • Humans
  • Female
 

Citation

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Peng, C. W., Chen, J. J. J., Cheng, C. L., & Grill, W. M. (2008). Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents. Journal Of Neural Engineering, 5(2), 144–154.
Peng, C. W., J. J. J. Chen, C. L. Cheng, and W. M. Grill. “Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents.” Journal Of Neural Engineering 5, no. 2 (June 2008): 144–54.
Peng CW, Chen JJJ, Cheng CL, Grill WM. Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents. Journal Of Neural Engineering. 2008 Jun;5(2):144–54.
Peng, C. W., et al. “Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents.” Journal Of Neural Engineering, vol. 5, no. 2, June 2008, pp. 144–54.
Peng CW, Chen JJJ, Cheng CL, Grill WM. Improved bladder emptying in urinary retention by electrical stimulation of pudendal afferents. Journal Of Neural Engineering. 2008 Jun;5(2):144–154.
Journal cover image

Published In

Journal Of Neural Engineering

ISSN

1741-2560

Publication Date

June 2008

Volume

5

Issue

2

Start / End Page

144 / 154

Related Subject Headings

  • Urination
  • Urinary Retention
  • Urinary Bladder
  • Treatment Outcome
  • Rats, Sprague-Dawley
  • Rats
  • Muscle, Smooth
  • Muscle Contraction
  • Humans
  • Female