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Chen J, Zhong Y, Shen B, Wang J, Shen Z, Beckel J, de Groat WC, Tai C. Superficial peroneal neuromodulation of nonobstructive urinary retention induced by prolonged pudendal afferent activity in cats. Am J Physiol Regul Integr Comp Physiol 2022; 322:R136-R143. [PMID: 34984922 PMCID: PMC8799394 DOI: 10.1152/ajpregu.00271.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The purpose of this study is to determine whether superficial peroneal nerve stimulation (SPNS) can improve nonobstructive urinary retention (NOUR) induced by prolonged pudendal nerve stimulation (PNS). In this exploratory acute study using eight cats under anesthesia, PNS and SPNS were applied by nerve cuff electrodes. Skin surface electrodes were also used for SPNS. A double lumen catheter was inserted via the bladder dome for bladder infusion and pressure measurement and to allow voiding without a physical urethral outlet obstruction. The voided and postvoid residual (PVR) volumes were also recorded. NOUR induced by repetitive (4-13 times) application of 30-min PNS significantly (P < 0.05) reduced voiding efficiency by 49.5 ± 16.8% of control (78.3 ± 7.9%), with a large PVR volume at 208.2 ± 82.6% of control bladder capacity. SPNS (1 Hz, 0.2 ms) at 1.5-2 times threshold intensity (T) for inducing posterior thigh muscle contractions was applied either continuously (SPNSc) or intermittently (SPNSi) during cystometrograms to improve the PNS-induced NOUR. SPNSc and SPNSi applied by nerve cuff electrodes significantly (P < 0.05) increased voiding efficiency to 74.5 ± 18.9% and 67.0 ± 15.3%, respectively, and reduced PVR volume to 54.5 ± 39.0% and 88.3 ± 56.0%, respectively. SPNSc and SPNSi applied noninvasively by skin surface electrodes also improved NOUR similar to the stimulation applied by a cuff electrode. This study indicates that abnormal pudendal afferent activity could be a pathophysiological cause for the NOUR occurring in Fowler's syndrome and a noninvasive superficial peroneal neuromodulation therapy might be developed to treat NOUR in patients with Fowler's syndrome.
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Affiliation(s)
- Jialiang Chen
- 1Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania,2Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People’s Republic of China
| | - Yihua Zhong
- 1Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania,3School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China
| | - Bing Shen
- 1Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jicheng Wang
- 1Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Zhijun Shen
- 1Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan Beckel
- 4Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - William C. de Groat
- 4Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Changfeng Tai
- 1Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania,4Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania,5Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
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Chen J, Mohapatra A, Zhao J, Zhong Y, Shen B, Wang J, Shen Z, Beckel J, de Groat WC, Tai C. Superficial peroneal neuromodulation of persistent bladder underactivity induced by prolonged pudendal afferent nerve stimulation in cats. Am J Physiol Regul Integr Comp Physiol 2021; 320:R675-R682. [PMID: 33719564 DOI: 10.1152/ajpregu.00346.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The purpose of this study is to determine whether superficial peroneal nerve stimulation (SPNS) can reverse persistent bladder underactivity induced by prolonged pudendal nerve stimulation (PNS). In 16 α-chloralose-anesthetized cats, PNS and SPNS were applied by nerve cuff electrodes. Skin surface electrodes were also used for SPNS. Bladder underactivity consisting of a significant increase in bladder capacity to 157.8 ± 10.9% of control and a significant reduction in bladder contraction amplitude to 56.0 ± 5.0% of control was induced by repetitive (4-16 times) application of 30-min PNS. SPNS (1 Hz, 0.2 ms) at 1.5-2 times threshold intensity (T) for inducing posterior thigh muscle contractions was applied either continuously (SPNSc) or intermittently (SPNSi) during a cystometrogram (CMG) to determine whether the stimulation can reverse the PNS-induced bladder underactivity. SPNSc or SPNSi applied by nerve cuff electrodes during the prolonged PNS inhibition significantly reduced bladder capacity to 124.4 ± 10.7% and 132.4 ± 14.2% of control, respectively, and increased contraction amplitude to 85.3 ± 6.2% and 75.8 ± 4.7%, respectively. Transcutaneous SPNSc and SPNSi also significantly reduced bladder capacity and increased contraction amplitude. Additional PNS applied during the bladder underactivity further increased bladder capacity, whereas SPNSc applied simultaneously with the PNS reversed the increase in bladder capacity. This study indicates that a noninvasive superficial peroneal neuromodulation therapy might be developed to treat bladder underactivity caused by abnormal pudendal nerve somatic afferent activation that is hypothesized to occur in patients with Fowler's syndrome.
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Affiliation(s)
- Jialiang Chen
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People's Republic of China
| | - Anand Mohapatra
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jun Zhao
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Urology, The Second Affiliated Hospital of Xian Jiaotong University, Xian, People's Republic of China
| | - Yihua Zhong
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,School of Biomedical Engineering, Capital Medical University, Beijing, People's Republic of China
| | - Bing Shen
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jicheng Wang
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Zhijun Shen
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan Beckel
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - William C de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Changfeng Tai
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
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Zhao J, Chen J, Guo W, Shapiro K, Mohapatra A, Zhong Y, Armann K, Shen B, Wang J, Beckel J, de Groat WC, Tai C. Superficial peroneal neuromodulation of nonobstructive urinary retention in cats. Neurourol Urodyn 2020; 39:1679-1686. [PMID: 32542996 DOI: 10.1002/nau.24438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/07/2020] [Indexed: 01/06/2023]
Abstract
AIMS To determine if superficial peroneal nerve stimulation (SPNS) can improve nonobstructive urinary retention (NOUR). METHODS In α-chloralose anesthetized cats, NOUR was induced by repetitive application (4-16 times) of 30-minute tibial nerve stimulation (TNS: 5 Hz frequency, 0.2 ms pulse width) at 4 to 6 times threshold intensity (T) for inducing toe twitches. SPNS (1 Hz, 0.2 ms) at 2 to 4 times threshold intensity (T) for inducing posterior thigh muscle contractions was applied either continuously (SPNSc) during a cystometrogram (CMG) or during voiding (SPNSv) by a surgically implanted cuff electrode or by skin surface electrodes to determine if the stimulation reduced NOUR induced by prolonged TNS. RESULTS During control CMGs, efficient (86.4% ± 5.5%) voiding occurred with a postvoid residual (PVR) volume equal to 14.9% ± 6.2% of control bladder capacity. NOUR elicited by prolonged TNS significantly (P < .05) increased bladder capacity to 168.6% ± 15.5% of control, reduced voiding efficiency to 30.4% ± 4.8%, and increased PVR to 109% ± 9.2% of control. Using the implanted cuff electrode, SPNSc and SPNSv significantly (P < .05) increased voiding efficiency to 66.7% ± 7.4% and 65.0% ± 5.9%, respectively, and reduced PVR to 52.2% ± 11.4% and 64.3% ± 11.6%, respectively. SPNSc but not SPNSv significantly (P < .05) reduced bladder capacity to 133.4% ± 15% of control. Transcutaneous SPNSv but not SPNSc also significantly (P < .05) reversed the TNS-induced NOUR responses. CONCLUSIONS This study shows that SPNS is effective in reversing NOUR induced by prolonged TNS. Transcutaneous SPNS provides the opportunity to develop a noninvasive neuromodulation therapy for NOUR to treat more patients than current sacral neuromodulation therapy.
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Affiliation(s)
- Jun Zhao
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Urology, The Second Affiliated Hospital of Xian Jiaotong University, Xian, China
| | - Jialiang Chen
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Urology, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wenbin Guo
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Urology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Katherine Shapiro
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anand Mohapatra
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Yihua Zhong
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,School of Biomedical Engineering, Capital Medical University, Beijing, China
| | - Kody Armann
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bing Shen
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jicheng Wang
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jonathan Beckel
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - William C de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Changfeng Tai
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
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Underactive Bladder and Bladder Outlet Procedures in Women. CURRENT BLADDER DYSFUNCTION REPORTS 2020; 15:21-24. [PMID: 32467746 DOI: 10.1007/s11884-019-00572-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Purpose of review This review outlines current options for women suffering from both stress urinary incontinence (SUI) and underactive bladder (UAB). This is often a challenging patient population; however, many treatment options are available including behavioral, pharmacologic, and surgical. Therapies can be divided into those specifically targeting either the bladder or the bladder outlet. Recent findings For patients with SUI and UAB, several clinical trials have helped to formulate current guidelines. Also, a number of novel techniques and therapeutic agents are currently under investigation. Current surgical treatments frequently employed for SUI include midurethral slings and urethral bulking agents. In contrast, the current treatments for UAB are limited to either sacral neuromodulation in women with Fowlers syndrome or in the majority, clean intermittent catheterization. Recent studies have investigated the use of adjustable urethral slings and novel modes of neuromodulation with varying degrees of success. Summary Choosing the best treatment plan for SUI combined with UAB involves a thorough understanding of a patient's preferences and goals. Fortunately, women have many options that can significantly benefit their quality of life.
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Li S, Browning J, Theisen K, Yecies T, Shen B, Wang J, Roppolo JR, de Groat WC, Tai C. Prolonged nonobstructive urinary retention induced by tibial nerve stimulation in cats. Am J Physiol Regul Integr Comp Physiol 2020; 318:R428-R434. [PMID: 31913685 DOI: 10.1152/ajpregu.00277.2019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Nonobstructive urinary retention (NOUR) is a medical condition without an effective drug treatment, but few basic science studies have focused on this condition. In α-chloralose-anesthetized cats, the bladder was cannulated via the dome and infused with saline to induce voiding that could occur without urethral outlet obstruction. A nerve cuff electrode was implanted for tibial nerve stimulation (TNS). The threshold (T) intensity for TNS to induce toe twitch was determined initially. Repeated (6 times) application of 30-min TNS (5 Hz, 0.2 ms, 4-6T) significantly (P < 0.05) increased bladder capacity to 180% of control and reduced the duration of the micturition contraction to 30% of control with a small decrease in contraction amplitude (80% of control), which resulted in urinary retention with a low-voiding efficiency of 30% and a large amount of residual volume equivalent to 130% of control bladder capacity. This NOUR condition persisted for >2 h after the end of repeated TNS. However, lower frequency TNS (1 Hz, 0.2 ms, 4T) applied during voiding partially reversed the NOUR by significantly (P < 0.05) increasing voiding efficiency to 60% and reducing residual volume to 70% of control bladder capacity without changing bladder capacity. These results revealed that tibial nerve afferent input can activate either an excitatory or an inhibitory central nervous system mechanism depending on afferent firing frequencies (1 vs. 5 Hz). This study established the first NOUR animal model that will be useful for basic science research aimed at developing new treatments for NOUR.
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Affiliation(s)
- Shun Li
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, People's Republic of China
| | - Jeffery Browning
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Katherine Theisen
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Todd Yecies
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bing Shen
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jicheng Wang
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - James R Roppolo
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - William C de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Changfeng Tai
- Department of Urology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania
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Zhang Y, Li S, Yecies T, Morgan T, Cai H, Pace N, Shen B, Wang J, Roppolo JR, de Groat WC, Tai C. Sympathetic afferents in the hypogastric nerve facilitate nociceptive bladder activity in cats. Am J Physiol Renal Physiol 2019; 316:F703-F711. [PMID: 30672315 DOI: 10.1152/ajprenal.00522.2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
This study in α-chloralose-anesthetized cats revealed a role of hypogastric nerve afferent axons in nociceptive bladder activity induced by bladder irritation using 0.25% acetic acid (AA). In cats with intact hypogastric and pelvic nerves, AA irritation significantly ( P < 0.05) reduced bladder capacity to 45.0 ± 5.7% of the control capacity measured during a saline cystometrogram (CMG). In cats with the hypogastric nerves transected bilaterally, AA irritation also significantly ( P < 0.05) reduced bladder capacity, but the change was significantly smaller (capacity reduced to 71.5 ± 10.6% of saline control, P < 0.05) than that in cats with an intact hypogastric nerve. However, application of hypogastric nerve stimulation (HGNS: 20 Hz, 0.2 ms pulse width) to the central end of the transected nerves at an intensity (16 V) strong enough to activate C-fiber afferent axons facilitated the effect of AA irritation and further ( P < 0.05) reduced bladder capacity to 48.4 ± 7.4% of the saline control. This facilitation by HGNS was effective only at selected frequencies (1, 20, and 30 Hz) when the stimulation intensity was above the threshold for activating C-fibers. Tramadol (an analgesic agent) at 3 mg/kg iv completely blocked the nociceptive bladder activity and eliminated the facilitation by HGNS. HGNS did not alter non-nociceptive bladder activity induced by saline distention of the bladder. These results indicate that sympathetic afferents in the hypogastric nerve play an important role in the facilitation of the nociceptive bladder activity induced by bladder irritation that activates the silent C-fibers in the pelvic nerve.
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Affiliation(s)
- Yan Zhang
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Transplantation Center, First Affiliated Hospital of Wenzhou Medical University , Zhejiang , People's Republic of China
| | - Shun Li
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Department of Urology, Qianfoshan Hospital, Shandong University , Jinan , People's Republic of China
| | - Todd Yecies
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Tara Morgan
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Haotian Cai
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Natalie Pace
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Bing Shen
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Jicheng Wang
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - James R Roppolo
- Department of Pharmacology and Chemical Biology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - William C de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Changfeng Tai
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Department of Pharmacology and Chemical Biology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh , Pittsburgh, Pennsylvania
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Theisen K, Browning J, Li X, Li S, Shen B, Wang J, Roppolo JR, de Groat WC, Tai C. Frequency Dependent Tibial Neuromodulation of Bladder Underactivity and Overactivity in Cats. Neuromodulation 2018; 21:700-706. [PMID: 29949663 DOI: 10.1111/ner.12792] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 02/26/2018] [Accepted: 03/20/2018] [Indexed: 12/20/2022]
Abstract
OBJECTIVE This study is aimed at determining if tibial nerve stimulation (TNS) can modulate both bladder underactivity and overactivity. METHODS In α-chloralose anesthetized cats, tripolar cuff electrodes were implanted on both tibial nerves and TNS threshold (T) for inducing toe twitching was determined for each nerve. Normal bladder activity was elicited by slow intravesical infusion of saline; while bladder overactivity was induced by infusion of 0.25% acetic acid to irritate the bladder. Bladder underactivity was induced during saline infusion by repeated application (2-6 times) of 30-min TNS (5 Hz, 4-8T, 0.2 msec) to the left tibial nerve, while TNS (1 Hz, 4T, 0.2 msec) was applied to the right tibial nerve to reverse the bladder underactivity. RESULTS Prolonged 5-Hz TNS induced bladder underactivity by significantly increasing bladder capacity to 173.8% ± 10.4% of control and reducing the contraction amplitude to 40.1% ± 15.3% of control, while 1 Hz TNS normalized the contraction amplitude and significantly reduced the bladder capacity to 130%-140% of control. TNS at 1 Hz in normal bladders did not change contraction amplitude and only slightly changed the capacity, but in both normal and underactive bladders significantly increased contraction duration. The effects of 1 Hz TNS did not persist following stimulation. Under isovolumetric conditions when the bladder was underactive, TNS (0.5-3 Hz; 1-4T) induced large amplitude and sustained bladder contractions. In overactive bladders, TNS during cystometry inhibited bladder overactivity at 5 Hz but not at 1 Hz. CONCLUSIONS This study indicates that TNS at different frequencies might be used to treat bladder underactivity and overactivity.
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Affiliation(s)
- Katherine Theisen
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeffery Browning
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Xing Li
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Urology, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital Medical University, Beijing, P.R. China
| | - Shun Li
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Urology, Qianfoshan Hospital, Shandong University, Jinan, P.R. China
| | - Bing Shen
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jicheng Wang
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA
| | - James R Roppolo
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - William C de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Changfeng Tai
- Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, PA, USA.,Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA
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Li S, Li X, Theisen K, Browning J, Shen B, Wang J, Roppolo JR, de Groat WC, Tai C. Saphenous nerve stimulation normalizes bladder underactivity induced by tibial nerve stimulation in cats. Am J Physiol Renal Physiol 2017; 315:F247-F253. [PMID: 29070575 DOI: 10.1152/ajprenal.00422.2017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
This study in α-chloralose-anesthetized cats aimed at investigating the bladder responses to saphenous nerve stimulation (SNS). A urethral catheter was used to infuse the bladder with saline and to record changes in bladder pressure. With the bladder fully distended, SNS at 1-Hz frequency and an intensity slightly below the threshold (T) for inducing an observable motor response of the hindlimb muscles induced large amplitude (40-150 cmH2O) bladder contractions. Application of SNS (1 Hz, 2-4T) during cystometrograms (CMGs), when the bladder was slowly (1-3 ml/min) infused with saline, significantly ( P < 0.05) increased the duration of the micturition contraction to >200% of the control without changing bladder capacity or contraction amplitude. Repeated application (1-8 times) of intense (4-8T intensity) 30-min tibial nerve stimulation (TNS) produced prolonged post-TNS inhibition that significantly ( P < 0.01) increased bladder capacity to 135.9 ± 7.6% and decreased the contraction amplitude to 44.1 ± 16.5% of the pre-TNS control level. During the period of post-TNS inhibition, SNS (1 Hz, 2-4T) applied during CMGs completely restored the bladder capacity and the contraction amplitude to the pre-TNS control level and almost doubled the duration of the micturition contraction. These results indicate that SNS at 1 Hz can facilitate the normal micturition reflex and normalize the reflex when it is suppressed during post-TNS inhibition. This study provides an opportunity to develop a novel neuromodulation therapy for underactive bladder using SNS.
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Affiliation(s)
- Shun Li
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Department of Urology, Qianfoshan Hospital, Shandong University , Jinan , People's Republic of China
| | - Xing Li
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Department of Urology, China Rehabilitation Research Center, School of Rehabilitation Medicine, Capital Medical University , Beijing , People's Republic of China
| | - Katherine Theisen
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Jeffery Browning
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Bing Shen
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Jicheng Wang
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - James R Roppolo
- Department of Pharmacology and Chemical Biology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - William C de Groat
- Department of Pharmacology and Chemical Biology, University of Pittsburgh , Pittsburgh, Pennsylvania
| | - Changfeng Tai
- Department of Urology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Department of Pharmacology and Chemical Biology, University of Pittsburgh , Pittsburgh, Pennsylvania.,Department of Bioengineering, University of Pittsburgh , Pittsburgh, Pennsylvania
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