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Pudendal nerve stimulation evokes reflex bladder contractions in persons with chronic spinal cord injury
Author(s) -
Yoo Paul B.,
Klein Stephen M.,
Grafstein Neil H.,
Horvath Eric E.,
Amundsen Cindy L.,
Webster George D.,
Grill Warren M.
Publication year - 2007
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.20441
Subject(s) - pudendal nerve , medicine , reflex , spinal cord injury , stimulation , excitatory postsynaptic potential , urination , anesthesia , external anal sphincter , spinal cord , trunk , urinary bladder , pelvic floor , electromyography , anatomy , urology , anal canal , urinary system , surgery , inhibitory postsynaptic potential , physical medicine and rehabilitation , rectum , ecology , psychiatry , biology
Aims Although electrical stimulation of the pudendal nerve has been shown to evoke reflex micturition‐like bladder contractions in both intact and spinalized cats, there is little evidence to suggest that an analogous excitatory reflex exists in humans, particularly those with spinal cord injury (SCI). We present two cases where electrical activation of pudendal nerve afferents was used to evoke excitatory bladder responses. Subjects and Methods A percutaneously placed catheter electrode was used to electrically stimulate the pudendal nerve trunk in two males with SCI. The response was quantified with recorded changes in detrusor pressure and EMG activity of the external anal sphincter. Results In both individuals, frequency specific (f = 20–50 Hz) activation of the pudendal nerve trunk evoked excitatory bladder contractions that also depended on the stimulus amplitude and bladder volume. Conclusion The results suggest that selective activation of the perineal branches of the pudendal nerve may further augment the excitatory reflex evoked by electrical stimulation. Neurourol. Urodynam. 26:1020–1023, 2007. © 2007 Wiley‐Liss, Inc.