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Neurorehabil Neural Repair. 2009 Jul-Aug;23(6):615-26. doi: 10.1177/1545968308328723. Epub 2008 Dec 24.

Transcutaneously coupled, high-frequency electrical stimulation of the pudendal nerve blocks external urethral sphincter contractions.

Author information

1
Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.

Abstract

BACKGROUND:

Detrusor-sphincter dyssynergia is a condition in which reflexive contractions of the external urethral sphincter occur during bladder contractions, preventing the expulsion of urine. High-frequency stimulation (kHz range) has been shown to elicit a fast-acting and reversible block of action potential propagation in peripheral nerves, which may be a useful technique in the management of this condition.

OBJECTIVE:

The aim of these experiments was to see if a newly developed stimulus delivery system, capable of transmitting current transcutaneously to remote peripheral nerves using a passive implanted conductor, was an effective way to transmit high-frequency waveforms to the pudendal nerve to block ongoing sphincter contractions.

METHODS:

High-frequency waveforms were delivered through the skin to the pudendal nerve using a passive implanted conductor in 6 adult cats anesthetized with isoflurane. Five of the experiments were acute, terminal procedures, and the remaining cat was implanted with a permanent electrode system allowing evaluation for 6 months. Typical stimulation parameters were in the range of 1 to 10 kHz and 1 to 10 mA.

RESULTS:

Complete blocking of external urethral sphincter contractions was achieved in 5 of the 6 animals. High-frequency stimulation was also tested in the chronically implanted animal without anesthesia, and the stimulation was tolerated with minimal aversive reactions.

CONCLUSIONS:

The transcutaneous passive implanted conductor stimulus delivery system is an effective way to stimulate the pudendal nerve at high frequency, leading to sphincter relaxation. This system may provide a simple means to implement this stimulation paradigm in people with detrusor-sphincter dyssynergia.

PMID:
19109445
DOI:
10.1177/1545968308328723
[Indexed for MEDLINE]

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