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  4. Selective Co-stimulation of Pudendal Afferents Enhances Reflex Bladder Activation

Selective Co-stimulation of Pudendal Afferents Enhances Reflex Bladder Activation

Conf Proc IEEE Eng Med Biol Soc, 2011 · DOI: 10.1109/IEMBS.2011.6090246 · Published: January 1, 2011

Spinal Cord InjuryUrologyBiomedical

Simple Explanation

This research investigates a method to improve bladder function in individuals with spinal cord injuries (SCI) using electrical stimulation. The conventional methods have limitations, so this study explores stimulating specific nerve branches to enhance bladder control. The study involved experiments on anesthetized cats and a human participant with SCI. The co-stimulation of two pudendal nerve branches (CSN and DNP) was tested to see if it could improve bladder contractions and voiding efficiency. The study found that co-stimulation of these nerve branches resulted in larger bladder contractions in cats and improved voiding efficiency in the human participant, suggesting a potential for new neural prosthetics for bladder control in SCI patients.

Study Duration
Not specified
Participants
3 cats, 1 human with chronic SCI
Evidence Level
Pre-clinical and Clinical Experiments

Key Findings

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    Co-stimulation of CSN and DNP evoked larger bladder contractions than individual stimulation of either CSN or DNP in anesthetized cats.
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    In a human with chronic SCI, co-stimulation of the proximal and distal urethra improved voiding efficiency compared to reflex distension-evoked voiding.
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    Bladder contraction pressures were dependent on electrode location, stimulation frequency, and stimulation amplitude in the human SCI participant.

Research Summary

This study investigates the use of selective co-stimulation of pudendal nerve afferents to enhance reflex bladder activation and improve bladder voiding efficiency in individuals with spinal cord injury (SCI). The study found that co-stimulation of the cranial urethral sensory nerve (CSN) and the dorsal nerve of the penis (DNP) evoked larger bladder contractions in anesthetized cats compared to individual stimulation of either nerve. Clinical experiments with a participant with chronic SCI showed that co-stimulation of the proximal and distal urethra improved voiding efficiency when compared to reflex distension-evoked voiding, suggesting the potential for future neural prosthetics.

Practical Implications

Neural Prosthetics Development

The findings support the development of neural prosthetics for restoring bladder function in individuals with SCI by utilizing selective co-stimulation techniques.

Improved Voiding Efficiency

Co-stimulation can significantly improve voiding efficiency, reducing the need for intermittent catheterization and minimizing complications associated with bladder dysfunction.

Personalized Stimulation Strategies

The study highlights the importance of considering electrode location, stimulation frequency, and amplitude for optimizing bladder contractions, suggesting the need for personalized stimulation strategies.

Study Limitations

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