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Superficial peroneal neuromodulation of nonobstructive urinary retention in cats
Author(s) -
Zhao Jun,
Chen Jialiang,
Guo Wenbin,
Shapiro Katherine,
Mohapatra Anand,
Zhong Yihua,
Armann Kody,
Shen Bing,
Wang Jicheng,
Beckel Jonathan,
Groat William C.,
Tai Changfeng
Publication year - 2020
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.24438
Subject(s) - medicine , urology , cuff , urinary retention , stimulation , anesthesia , tibial nerve , urinary incontinence , urinary bladder , surgery
Aims To determine if superficial peroneal nerve stimulation (SPNS) can improve nonobstructive urinary retention (NOUR). Methods In α‐chloralose anesthetized cats, NOUR was induced by repetitive application (4‐16 times) of 30‐minute tibial nerve stimulation (TNS: 5 Hz frequency, 0.2 ms pulse width) at 4 to 6 times threshold intensity (T) for inducing toe twitches. SPNS (1 Hz, 0.2 ms) at 2 to 4 times threshold intensity (T) for inducing posterior thigh muscle contractions was applied either continuously (SPNSc) during a cystometrogram (CMG) or during voiding (SPNSv) by a surgically implanted cuff electrode or by skin surface electrodes to determine if the stimulation reduced NOUR induced by prolonged TNS. Results During control CMGs, efficient (86.4% ± 5.5%) voiding occurred with a postvoid residual (PVR) volume equal to 14.9% ± 6.2% of control bladder capacity. NOUR elicited by prolonged TNS significantly ( P < .05) increased bladder capacity to 168.6% ± 15.5% of control, reduced voiding efficiency to 30.4% ± 4.8%, and increased PVR to 109% ± 9.2% of control. Using the implanted cuff electrode, SPNSc and SPNSv significantly ( P < .05) increased voiding efficiency to 66.7% ± 7.4% and 65.0% ± 5.9%, respectively, and reduced PVR to 52.2% ± 11.4% and 64.3% ± 11.6%, respectively. SPNSc but not SPNSv significantly ( P < .05) reduced bladder capacity to 133.4% ± 15% of control. Transcutaneous SPNSv but not SPNSc also significantly ( P < .05) reversed the TNS‐induced NOUR responses. Conclusions This study shows that SPNS is effective in reversing NOUR induced by prolonged TNS. Transcutaneous SPNS provides the opportunity to develop a noninvasive neuromodulation therapy for NOUR to treat more patients than current sacral neuromodulation therapy.