Abstract

Background/Purpose: Few studies have investigated the feasibility of using pudendal neuromodulation to regulate bladder function in spinal cord-injured (SCI) animals. The present study aimed to determine the effects of electrical activation of the pudendal sensory branch on improving voiding functions in rats 6 weeks after a spinal cord injury and to explore the underlying neuromodulatory mechanisms. Methods: Two urodynamic measurements were used to assess the effects of electrical stimulation (ES) on bladder and urethral functions: simultaneous recordings of the intravesical pressure (IVP) during continuous isotonic transvesical infusion (i.e., isotonic IVP) and external urethral sphincter (EUS) electromyography (EUS-EMG), and simultaneous recordings of transvesical pressure under isovolumetric conditions (i.e., isovolumetric IVP) and urethral perfusion pressure (UPP). Results: Six weeks after the SCI, the rats showed voiding dysfunction, as indicated by abnormal cystometric measurements (e.g., increased volume threshold, increased contraction amplitude, and increased residual volume, and decreased voided volume). The voiding efficiency (VE) decreased to 13% after the SCI, but increased to 22-34% after applying pudendal afferent stimulation. In addition, pudendal stimulation significantly increased the EUS burst period and increased the difference between the UPP and the high-frequency oscillation (HFO) baselines, and changed the time offset between bladder and EUS activities. These findings suggest that pudendal afferent stimulation improved the VE by prolonging the micturition interval, decreased the urethral resistance, and recovered detrusor-sphincter dyssynergia during the voiding phase. Conclusion: This study demonstrates the feasibility of using pudendal neuromodulation in chronic SCI rats. These results could aid in developing an advanced neural prosthesis to restore bladder function in clinical settings.

Original languageEnglish
Pages (from-to)703-713
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume115
Issue number9
DOIs
Publication statusPublished - Sep 1 2016

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Spinal Cord
Urinary Bladder
Pressure
Urethra
Neural Prostheses
Perfusion
Residual Volume
Urination
Urodynamics
Feasibility Studies
Electromyography
Ataxia
Spinal Cord Injuries
Electric Stimulation

Keywords

  • Electrical stimulation
  • Intravesical pressure
  • Pudendal nerve
  • Spinal cord injury
  • Voiding efficiency

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Effects of pudendal neuromodulation on bladder function in chronic spinal cord-injured rats. / Lin, Yin Tsong; Hsieh, Tsung Hsun; Chen, Shih Ching; Lai, Chien Hung; Kuo, Te Son; Chen, Chung Ping; Lin, Chii Wann; Young, Shuenn Tsong; Peng, Chih Wei.

In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 115, No. 9, 01.09.2016, p. 703-713.

Research output: Contribution to journalArticle

Lin, Yin Tsong ; Hsieh, Tsung Hsun ; Chen, Shih Ching ; Lai, Chien Hung ; Kuo, Te Son ; Chen, Chung Ping ; Lin, Chii Wann ; Young, Shuenn Tsong ; Peng, Chih Wei. / Effects of pudendal neuromodulation on bladder function in chronic spinal cord-injured rats. In: Journal of the Formosan Medical Association = Taiwan yi zhi. 2016 ; Vol. 115, No. 9. pp. 703-713.
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abstract = "Background/Purpose: Few studies have investigated the feasibility of using pudendal neuromodulation to regulate bladder function in spinal cord-injured (SCI) animals. The present study aimed to determine the effects of electrical activation of the pudendal sensory branch on improving voiding functions in rats 6 weeks after a spinal cord injury and to explore the underlying neuromodulatory mechanisms. Methods: Two urodynamic measurements were used to assess the effects of electrical stimulation (ES) on bladder and urethral functions: simultaneous recordings of the intravesical pressure (IVP) during continuous isotonic transvesical infusion (i.e., isotonic IVP) and external urethral sphincter (EUS) electromyography (EUS-EMG), and simultaneous recordings of transvesical pressure under isovolumetric conditions (i.e., isovolumetric IVP) and urethral perfusion pressure (UPP). Results: Six weeks after the SCI, the rats showed voiding dysfunction, as indicated by abnormal cystometric measurements (e.g., increased volume threshold, increased contraction amplitude, and increased residual volume, and decreased voided volume). The voiding efficiency (VE) decreased to 13{\%} after the SCI, but increased to 22-34{\%} after applying pudendal afferent stimulation. In addition, pudendal stimulation significantly increased the EUS burst period and increased the difference between the UPP and the high-frequency oscillation (HFO) baselines, and changed the time offset between bladder and EUS activities. These findings suggest that pudendal afferent stimulation improved the VE by prolonging the micturition interval, decreased the urethral resistance, and recovered detrusor-sphincter dyssynergia during the voiding phase. Conclusion: This study demonstrates the feasibility of using pudendal neuromodulation in chronic SCI rats. These results could aid in developing an advanced neural prosthesis to restore bladder function in clinical settings.",
keywords = "Electrical stimulation, Intravesical pressure, Pudendal nerve, Spinal cord injury, Voiding efficiency",
author = "Lin, {Yin Tsong} and Hsieh, {Tsung Hsun} and Chen, {Shih Ching} and Lai, {Chien Hung} and Kuo, {Te Son} and Chen, {Chung Ping} and Lin, {Chii Wann} and Young, {Shuenn Tsong} and Peng, {Chih Wei}",
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AU - Hsieh, Tsung Hsun

AU - Chen, Shih Ching

AU - Lai, Chien Hung

AU - Kuo, Te Son

AU - Chen, Chung Ping

AU - Lin, Chii Wann

AU - Young, Shuenn Tsong

AU - Peng, Chih Wei

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AB - Background/Purpose: Few studies have investigated the feasibility of using pudendal neuromodulation to regulate bladder function in spinal cord-injured (SCI) animals. The present study aimed to determine the effects of electrical activation of the pudendal sensory branch on improving voiding functions in rats 6 weeks after a spinal cord injury and to explore the underlying neuromodulatory mechanisms. Methods: Two urodynamic measurements were used to assess the effects of electrical stimulation (ES) on bladder and urethral functions: simultaneous recordings of the intravesical pressure (IVP) during continuous isotonic transvesical infusion (i.e., isotonic IVP) and external urethral sphincter (EUS) electromyography (EUS-EMG), and simultaneous recordings of transvesical pressure under isovolumetric conditions (i.e., isovolumetric IVP) and urethral perfusion pressure (UPP). Results: Six weeks after the SCI, the rats showed voiding dysfunction, as indicated by abnormal cystometric measurements (e.g., increased volume threshold, increased contraction amplitude, and increased residual volume, and decreased voided volume). The voiding efficiency (VE) decreased to 13% after the SCI, but increased to 22-34% after applying pudendal afferent stimulation. In addition, pudendal stimulation significantly increased the EUS burst period and increased the difference between the UPP and the high-frequency oscillation (HFO) baselines, and changed the time offset between bladder and EUS activities. These findings suggest that pudendal afferent stimulation improved the VE by prolonging the micturition interval, decreased the urethral resistance, and recovered detrusor-sphincter dyssynergia during the voiding phase. Conclusion: This study demonstrates the feasibility of using pudendal neuromodulation in chronic SCI rats. These results could aid in developing an advanced neural prosthesis to restore bladder function in clinical settings.

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