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Technical Brief

Neuromodulation on Bladder Capacity in Conscious Sheep1

[+] Author and Article Information
Xin Su, Thaddeus Brink, Dwight E. Nelson

Global Neuromodulation Research,
Minneapolis, MN 55432

Angela Nickles

Physiology Research Laboratory,
Minneapolis, MN 55432

Accepted and presented at the Design of Medical Devices Conference (DMD2014), Minneapolis, MN, April 7–10, 2014.

Manuscript received February 21, 2014; final manuscript received February 28, 2014; published online April 28, 2014. Editor: Arthur G. Erdman.

J. Med. Devices 8(2), 020924 (Apr 28, 2014) (2 pages) Paper No: MED-14-1052; doi: 10.1115/1.4027023 History: Received February 21, 2014; Revised February 28, 2014

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References

Abrams, P., Andersson, K. E., Birder, L., Brubaker, L., Cardozo, L., Chapple, C., Cottenden, A., Davila, W., de Ridder, D., Dmochowski, R., Drake, M., Dubeau, C., Fry, C., Hanno, P., Smith, J. H., Herschorn, S., Hosker, G., Kelleher, C., Koelbl, H., Khoury, S., Madoff, R., Milsom, I., Moore, K., Newman, D., Nitti, V., Norton, C., Nygaard, I., Payne, C., Smith, A., Staskin, D., Tekgul, S., Thuroff, J., Tubaro, A., Vodusek, D., Wein, A., Wyndaele, J. J., and Members of Committees, 2010, “Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: Evaluation and Treatment of Urinary Incontinence, Pelvic Organ Prolapse, and Fecal Incontinence,” Neurourol. Urodyn., 29(1), pp. 213–240. [CrossRef]
Su, X., Nickles, A., and Nelson, D. E., 2012, “Neuromodulation in a Rat Model of the Bladder Micturition Reflex,” Am. J. Physiol. Renal Physiol., 302(4), pp. F477–F486. [CrossRef]
Snellings, A. E., and Grill, W. M., 2012, “Effects of Stimulation Site and Stimulation Parameters on Bladder Inhibition by Electrical Nerve Stimulation,” BJU Int., 110(1), pp. 136–143. [CrossRef]
Su, X., Nickles, A., and Nelson, D. E., 2013, “Differentiation and Interaction of Tibial Versus Spinal Nerve Stimulation for Micturition Control in the Rat,” Neurourol. Urodyn. (in press). [CrossRef]
Peters, K. M., Shen, L., and McGuire, M., 2013, “Effect of Sacral Neuromodulation Rate on Overactive Bladder Symptoms: A Randomized Crossover Feasibility Study,” LUTS: Lower Urinary Tract Symptoms, 5(3), pp. 129–133. [CrossRef]
Zhang, F., Zhao, S., Shen, B., Wang, J., Nelson, D. E., Roppolo, J. R., de Groat, W. C., and Tai, C., 2013, “Neural Pathways Involved in Sacral Neuromodulation of Reflex Bladder Activity in Cats,”Am. J. Physiol. Renal Physiol., 304(6), pp. F710–F717. [CrossRef]
Su, X., Nickles, A., and Nelson, D. E., 2013, “The Role of the Endogenous Opioid System in Modulation of Urinary Bladder Activity by Spinal Nerve Stimulation,” Am. J. Physiol. Renal Physiol., 305(1), pp. F52–F60. [CrossRef]
Wang, Y., Zhou, Y., Mourad, M. S., and Hassouna, M. M., 2000, “Neuromodulation Reduces Urinary Frequency in Rats With Hydrochloric Acid-Induced Cystitis,” BJU Int., 86(6), pp. 726–730. [CrossRef]
Shaker, H., Wang, Y., Loung, D., Balbaa, L., Fehlings, M. G., and Hassouna, M. M., 2000, “Role of C-Afferent Fibers in the Mechanism of Action of Sacral Nerve Root Neuromodulation in Chronic Spinal Cord Injury,” BJU Int., 85(7), pp. 905–910. [CrossRef]
Comiter, C. V., Mazar, C., Phull, H., and Salkini, M., 2010, “Chronic Sacral Nerve Stimulation Prevents Detrusor Structural and Functional Changes Associated With Bladder Outlet Obstruction—A Rat Model,” Neurourol. Urodyn., 29(5), pp. 783–788. [CrossRef]
Hussain, Z., and Harrison, S. V. W., 2007, “Neuromodulation for Lower Urinary Tract Dysfunction—An Update,” Sci. World J., 7, pp. 1036–1045. [CrossRef]
Su, X., Nickles, A., and Nelson, D. E., 2013, “Neuromodulation Attenuates Bladder Irritation in a Rat Cystitis Model,” BMC Urol., 13, p. 70. [CrossRef]

Figures

Grahic Jump Location
Fig. 1

Representative recording prior to ((a), no stim) and with (b) bilateral sacral neuromodulation at VMax (VMax stim, 10 Hz, pulse-width = 0.21 ms). Time scale is shown above the graph.

Grahic Jump Location
Fig. 2

Effects of sacral neuromodulation on bladder capacity measured using urodynamics. Filled symbols denote measures during stimulation. Open symbols are measures without stimulation. Sacral neuromodulation during voids 4–5 applied at VTh (10 Hz, 0.21 ms pulse-width) caused no change in capacity while stimulation at VMax caused transient but nonsignificant increases in mean capacity. On a subsequent test, neuromodulation during voids 4–10 induced significant increases in capacity over baseline. Responses are represented as a percentage of baseline control capacities (mean of voids 2–3).

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