Does electrical stimulation in the lower urinary tract increase urine production? A randomised comparative proof-of-concept study in healthy volunteers

PLoS ONE, 2019 · DOI: 10.1371/journal.pone.0217503 · Published: May 24, 2019

Simple Explanation

The study investigates whether electrical stimulation in the lower urinary tract (LUT) can increase urine production. Ninety healthy volunteers were subjected to electrical stimulation at different locations in the LUT with varying frequencies, and their urine production was measured and compared to their baseline values. The results showed that electrical stimulation did increase urine production, especially with higher stimulation frequencies.

Study Duration

October 2015 and June 2017

Participants

90 healthy subjects (40 females and 50 males, 18 to 36 years old)

Evidence Level

Level 1, Randomized controlled trial, Proof-of-concept study

Key Findings

1
Lower urinary tract electrical stimulation increased urine production per time compared to bladder diary baseline values.
2
Frequency, stimulation order, intensity, and gender had a significant influence on urine production.
3
Stimulation location had no significant influence on UPT-ratio, however pairwise comparisons revealed higher UPT-ratio during stimulation at TG compared to dUR.

Research Summary

This study aimed to quantify urine production during electrical stimulation of the lower urinary tract using different stimulation frequencies in healthy volunteers. The study found that lower urinary tract electrical stimulation increased urine production per time compared to bladder diary baseline values. Urine production is increased during electrical stimulation with a bigger impact of higher frequencies, which may be relevant for methodological aspects and patients with impaired renal urine output.

Practical Implications

Methodological Implications

The findings are relevant for methodological aspects in assessing lower urinary tract afferent function, as rapid changes in bladder volume can affect measurements.

Therapeutic Potential

Electrical stimulation might be relevant for patients with impaired urine production, such as those with kidney or heart failure.

Physiological Understanding

The study contributes to understanding the relationship between lower urinary tract electrical stimulation and renal urine production, potentially involving altered renal sympathetic activity.

Study Limitations

1
Lack of volume measurements for each section (Dcath-Dempt) of the stimulation cycle to better differentiate the contribution of each section to the observed effect.
2
Baseline UPT during the measurement was possibly slightly underestimated since the catheter or contrast agent could lead to certain UPT increase, but this would not explain the strong frequency effect.
3
Further studies investigating age effects, possible confounders (i.e. catheter and contrast agent) and including assessments of the autonomic nervous system are mandatory

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