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Suppression of bladder overactivity by activation of somatic afferent nerves in the foot
Author(s) -
Tai Changfeng,
Shen Bing,
Chen Mang,
Wang Jicheng,
Liu Hailong,
Roppolo James R.,
de Groat William C.
Publication year - 2011
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2010.09358.x
Subject(s) - stimulation , medicine , overactive bladder , urination , anesthesia , urinary bladder , rhizotomy , urology , saline , spinal cord , anatomy , urinary system , pathology , psychiatry , alternative medicine
What’s known on the subject? and What does the study add? It is known that electrical stimulation of the sacral root, pudendal nerve, or tibial nerve can inhibit bladder overactivity. These stimulation methods require surgery or repeated clinical visits that are expensive and inconvenient. This study shows for the first time that electrical stimulation of the foot can suppress bladder overactivity. Stimulation of the foot is non‐invasive, easily accessible, and convenient, which could be a widely acceptable treatment for bladder overactivity. OBJECTIVE To investigate the possibility of suppressing bladder overactivity by electrical activation of somatic afferent nerves in the foot. MATERIALS AND METHODS Cats with an intact spinal cord were studied under α‐chloralose anaesthesia. Bladder pressure was recorded via a urethral catheter. Foot stimulation was applied via surface pad electrodes attached to the skin of the front or hind foot. RESULTS Reflex micturition was inhibited by electrical stimulation of the hind foot at either low (5 Hz) or high (20 Hz) frequencies, but stimulation of the front foot was ineffective. The mean ( sem ) bladder capacity during a saline infusion cystometrogram (CMG) was significantly ( P < 0.05) increased to 153.2 (18.2)% and 136.9 (14.3)% of the control bladder capacity by stimulation at frequencies of 5 Hz and 20 Hz, respectively. Intravesical infusion of 0.25% acetic acid (AA) induced bladder overactivity and reduced bladder capacity to 20.3 (8.9)% of the control capacity measured during saline infusion. Foot stimulation inhibited the AA‐induced bladder overactivity recorded under isovolumetric conditions, and significantly ( P < 0.05) increased bladder capacity during AA infusion. However, it only restored the small bladder capacity caused by AA irritation to 40–50% of the control bladder capacity measured during saline infusion. The effect of foot stimulation did not persist after termination of stimulation during repeated CMG tests. CONCLUSIONS This study shows the potential of noninvasive transcutaneous electrical stimulation of somatic nerves in the foot to inhibit reflex bladder activity and treat overactive bladder symptoms.