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Optimal conditions for the long-term modulation of the micturition reflex by intravesical electrical stimulation: an experimental study in the rat
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Cellbiologi. Linköpings universitet, Hälsouniversitetet.
Linköpings universitet, Institutionen för klinisk och experimentell medicin, Cellbiologi. Linköpings universitet, Hälsouniversitetet.
1999 (Engelska)Ingår i: BJU International, ISSN 1464-4096, Vol. 83, nr 4, s. 483-487Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVE: To determine whether induced bladder contractions influence the modulation by intravesical electrical stimulation (IVES) of the micturition reflex in anaesthetized rats, and to identify the optimal IVES frequency and duration.

MATERIALS AND METHODS: Seventy-six adult female rats, anaesthetized by alpha-chloralose. were divided into four groups to study the effect of: (i) IVES in combination with bladder contractions; (ii) bladder contractions alone; (iii) IVES frequency; and (iv) IVES duration. IVES was administered using a catheter electrode in the bladder. The effect of various IVES procedures was evaluated by determining the micturition threshold volume obtained from repeated cystometries before and after stimulation.

RESULTS: Administering IVES with standard parameters induced a significant decrease in the micturition threshold volume for about an hour. There was no difference in outcome between IVES with the bladder filled and contracting during the stimulation or empty and not contracting. Imposed bladder contractions per se had no effect on the micturition threshold volume. IVES at low frequencies (< or = 20 Hz) had a better modulatory effect than higher frequencies and the optimum duration of IVES was 5 min.

CONCLUSIONS: Evoked bladder contractions did not improve the IVES-induced modulation of the micturition reflex. These findings might help to improve the clinical application of the IVES procedure.

Ort, förlag, år, upplaga, sidor
1999. Vol. 83, nr 4, s. 483-487
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:liu:diva-13507OAI: oai:DiVA.org:liu-13507DiVA, id: diva2:20878
Tillgänglig från: 1999-02-25 Skapad: 1999-02-25 Senast uppdaterad: 2009-05-20
Ingår i avhandling
1. Prolonged Modulation of the Micturition Reflex by Electrical Stimulation
Öppna denna publikation i ny flik eller fönster >>Prolonged Modulation of the Micturition Reflex by Electrical Stimulation
1999 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Intravesical electrical stimulation (IVES) has been used in treatment of patients with urinary bladder dysfunctions for more than four decades. While some investigators have reported excellent results others have observed less convincing effects or outright failures. The discrepancies may reflect differences in patient selection or stimulation procedure. A better theoretical understanding of the IVES working mechanism might help to improve the success rate of the treatment. The aims of the present study were to provide such information.

Experiments were performed on adult female cats and rats under /alpha/-chloralose anesthesia. IVES was delivered by a catheter electrode in the bladder. At proper intensity and frequency, IVES evoked reflex detrusor contractions that were abolished by bilateral rhizotomy of sacral dorsal roots. Stimulation parameters and response characteristics revealed that bladder mechanoreceptor A/delta/ afferents were activated by the IVES, the same afferents that drive the normal micturition reflex.

Five minutes of continues IVES at 20 Hz induced a prolonged, significant decrease in the micturition threshold volume of anesthetized rats. Similarly, selective bladder A/delta/ afferent stimulation induced a long-lasting enhancement of micturition reflex discharges in cats. A comparable prolonged inhibitory effect on the micturition reflex was demonstrated after ano-genital afferent stimulation. Both modulatory effects occurred without changes in response sensitivity of stimulated afferents. The IVES induced modulation was prevented by transient exposure of the bladder to a local anesthetic and by systemic administration of a glutamate NMDA receptor antagonist.

In conclusion, IVES induces a prolonged modulation of the micturition reflex by an LTP like enhancement of excitatory synaptic transmission in the central micturition reflex pathway. The findings provide an experimental explanation for the neuronal mechanisms underlying the curative effect of IVES in patients with bladder evacuation problems.

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 1999. s. 50
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 582
Nyckelord
Intravesical electrical stimulation, IVES, bladder evacuation problems, bladder, micturition reflex
Nationell ämneskategori
Urologi och njurmedicin
Identifikatorer
urn:nbn:se:liu:diva-4989 (URN)91-7219-326-3 (ISBN)
Disputation
1999-02-12, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (Engelska)
Opponent
Handledare
Anmärkning
On the day of the public defence the status of article V was: Accepted.Tillgänglig från: 1999-02-25 Skapad: 1999-02-25 Senast uppdaterad: 2012-01-24Bibliografiskt granskad

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Jiang, Chong-HeLindström, Sivert

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