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Titolo:
The acute effects of continuous and conditional neuromodulation on the bladder in spinal cord injury
Autore:
Kirkham, APS; Shah, NC; Knight, SL; Shah, PJR; Craggs, MD;
Indirizzi:
Royal Natl Orthopaed Hosp, Spinal Injuries Unit, Neuroprostheses Res Ctr, Stanmore HA7 4LP, Middx, England Royal Natl Orthopaed Hosp Stanmore Middx England HA7 4LP , Middx, England
Titolo Testata:
SPINAL CORD
fascicolo: 8, volume: 39, anno: 2001,
pagine: 420 - 428
SICI:
1362-4393(200108)39:8<420:TAEOCA>2.0.ZU;2-5
Fonte:
ISI
Lingua:
ENG
Soggetto:
MAXIMAL ELECTRICAL-STIMULATION; SACRAL NERVE-STIMULATION; DETRUSOR HYPERREFLEXIA; URINARY-INCONTINENCE; URGE INCONTINENCE; INHIBITION; RECORDINGS; AFFERENTS; ROOTS; S3;
Keywords:
male; detrusor hyperreflexia; spinal cord injury; electric stimulation therapy; reflex physiology; penis; innervation;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
37
Recensione:
Indirizzi per estratti:
Indirizzo: Kirkham, APS Royal Natl Orthopaed Hosp, Spinal Injuries Unit, Neuroprostheses Res Ctr, Stanmore HA7 4LP, Middx, England Royal Natl Orthopaed Hosp Stanmore Middx England HA7 4LP and
Citazione:
A.P.S. Kirkham et al., "The acute effects of continuous and conditional neuromodulation on the bladder in spinal cord injury", SPINAL CORD, 39(8), 2001, pp. 420-428

Abstract

Study design: Laboratory investigation using serial slow-fill cystometrograms. Objectives: To examine the acute effects of different modes of dorsal penile nerve stimulation on detrusor hyperreflexia, bladder capacity and bladder compliance in spinal cord injury (SCI). Setting: Spinal Injuries Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK. Methods: Fourteen SCI patients were examined. Microtip transducer catheters enabled continuous measurement of anal sphincter, urethral sphincter and intravesical pressures. Control cystometrograms were followed by stimulation of the dorsal penile nerve at 15 Hz, 200 mus pulse width and amplitude equal to twice that which produced a pudendo-anal reflex. Stimulation was either continuous or in bursts of one minute triggered by a rise in detrusor pressure of 10 cm water (conditional). Further control cystometrograms were then performed to examine the residual effects of stimulation. Results: Bladder capacity increased significantly during three initial control fills. Continuous stimulation (n = 6) significantly increased bladder capacity by a mean of 110% ( Standard Deviation 85%) or 173 ml (+/- 146 ml), and bladder compliance by a mean of 53% (+/- 31%). Conditional stimulation in a different group of patients (n = 6) significantly increased bladder capacity, by 144% (+/- 127%) or 230 ml (+/- 143 ml). In the conditional neuromodulation experiments, the gap between suppressed contractions fell reliably as bladder volume increased, and the time from start of stimulation topeak of intravesical pressure and 50% decline in intravesical pressure rise was 2.8 s (+/- 0.9 s) and 7.6 s (+/- 1.0s) respectively. The two methods of stimulation were compared in six patients; in four out of six conditional neuromodulation resulted in a higher mean bladder capacity than continuous, but the difference was not significant. Conclusions: Both conditional and continuous stimulation significantly increase bladder capacity. The conditional mode is probably at least as effective as the continuous, suggesting that it could be used in an implanted device for bladder suppression.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 04/12/20 alle ore 11:51:43