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Intravesical electrical stimulation: an experimental analysis of the mechanism of action
Linköping University, Department of Clinical and Experimental Medicine, Cellbiology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Cellbiology. Linköping University, Faculty of Health Sciences.
1992 (English)In: Journal of Urology, ISSN 0022-5347, Vol. 148, no 3, 920-924 p.Article in journal (Refereed) Published
Abstract [en]

The working mechanism of intravesical electrical stimulation (IVES) was evaluated in alpha-chloralose anaesthetized cats and rats. IVES involved a direct activation of bladder mechanoreceptor afferents of the A delta type and as a consequence a central reflex activation of the detrusor. The detrusor response was abolished by bilateral transection of the S1-S3 dorsal roots and by intravesical instillation of lidocaine. The optimal stimulation frequency was 20 Hz. The results offer a theoretical rationale for the use of IVES as treatment of weak detrusor contractility in man.

Place, publisher, year, edition, pages
1992. Vol. 148, no 3, 920-924 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-13504OAI: diva2:20875
Available from: 1999-02-25 Created: 1999-02-25
In thesis
1. Prolonged Modulation of the Micturition Reflex by Electrical Stimulation
Open this publication in new window or tab >>Prolonged Modulation of the Micturition Reflex by Electrical Stimulation
1999 (English)Doctoral thesis, comprehensive summary (Other academic)
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.

Place, publisher, year, edition, pages
Linköping: Linköping University Electronic Press, 1999. 50 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 582
Intravesical electrical stimulation, IVES, bladder evacuation problems, bladder, micturition reflex
National Category
Urology and Nephrology
urn:nbn:se:liu:diva-4989 (URN)91-7219-326-3 (ISBN)
Public defence
1999-02-12, Berzeliussalen, Hälsouniversitetet, Campus US, Linköpings universitet, Linköping, 13:00 (English)
On the day of the public defence the status of article V was: Accepted.Available from: 1999-02-25 Created: 1999-02-25 Last updated: 2012-01-24Bibliographically approved

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