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- W4387357656 abstract "The stimulation paradigm for sacral neuromodulation has remained largely unchanged since its inception. We sought to determine, in rats, whether stimulation induced increases in bladder capacity correlated with the proportion of sensory pudendal (PudS) neurons at each stimulated location (L6, S1). If supported, this finding could guide the choice of stimulation side (left/right) and level (S2, S3, S4) in humans. Unexpectedly, we observed that acute stimulation at clinically-relevant (low) amplitudes (1-1.5x motor threshold or T m ), did not increase bladder capacity, regardless of stimulus location (L6 or S1). More importantly for the ability to test our hypothesis, there was little anatomical variation, and S1 infrequently contributed nerve fibers to the PudS nerve. During mapping studies we noticed large increases in PudS nerve activation occurred at amplitudes exceeding 2T m . Thus, additional cystometric studies were conducted, this time with stimulation of the L6-S1 trunk, to examine further the relationship between stimulation amplitude and cystometric parameters. Stimulation at 1-6T m evoked increases in bladder capacity and decreases in voiding efficiency that mirrored those produced by PudS nerve stimulation. Many animal studies involving electrical stimulation of nerves of the lower urinary tract use stimulation amplitudes that exceed those used clinically (~1T m ). Our results confirm that high amplitudes generate immediate changes in cystometric parameters, however the relationship to low-amplitude chronic stimulation in humans remains unclear. Additional studies are needed to understand changes that occur with chronic stimulation, how these changes relate to therapeutic outcomes, and the contribution of specific nerve fibers to these changes." @default.
- W4387357656 created "2023-10-06" @default.
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- W4387357656 date "2023-10-05" @default.
- W4387357656 modified "2023-10-06" @default.
- W4387357656 title "Pathways and Parameters of Sacral Neuromodulation in Rats" @default.
- W4387357656 doi "https://doi.org/10.1152/ajprenal.00123.2023" @default.
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