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Intravesical electrical stimulation induces a prolonged decrease in micturition threshold volume in the rat
Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
Linköping University, Department of Clinical and Experimental Medicine, Cell Biology. Linköping University, Faculty of Health Sciences.
1996 (English)In: Journal of Urology, ISSN 0022-5347, Vol. 155, no 4, 1477-1481 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: Intravesical electrical stimulation (IVES) has been used clinically to treat patients with voiding disorders. The aim of the present experimental study was to obtain objective evidence of a modulation of the micturition reflex by intravesical electrical stimulation (IVES).

Materials and Methods: Forty-one female rats, anesthetized by alpha-chloralose were used for the experiments. Intravesical electrical stimulation was given by a catheter electrode in the bladder (5 minutes of continuous stimulation at 20 Hz, 7 to 11 mA). The effect was evaluated by the change in cystometric micturition threshold volume.

Results: The threshold volume of the micturition reflex decreased significantly to 82% of controls after IVES (p<0.001; n=31). The effect was reversible and lasted for about 1 hour. The decrease was prevented by a transient blockade of the bladder nerves during IVES.

Conclusions: Intravesical electrical stimulation induced a prolonged modulation of the micturition reflex in anesthetized rats. The effect was due to activation of bladder mechanoreceptor afferents and remained long after the period of stimulation. It is proposed that the modulation was due to a prolonged enhancement of excitatory synaptic transmission in the central micturition reflex pathway. Such a modulation may underlie the curative effect of IVES in certain voiding disorders.

Place, publisher, year, edition, pages
1996. Vol. 155, no 4, 1477-1481 p.
Keyword [en]
stimulation
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-13505DOI: 10.1016/S0022-53470166310-9OAI: oai:DiVA.org:liu-13505DiVA: diva2:20876
Available from: 1999-02-25 Created: 1999-02-25 Last updated: 2009-05-20
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.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 582
Keyword
Intravesical electrical stimulation, IVES, bladder evacuation problems, bladder, micturition reflex
National Category
Urology and Nephrology
Identifiers
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)
Opponent
Supervisors
Note
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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Jiang, Chong-HeLindström, Sivert

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