Laparoscopic placement of a tined lead electrode on the pudendal nerve with urodynamic monitoring of bladder function during electrical stimulation: an acute experimental study in healthy female pigs

SpringerPlus, 2014 · DOI: 10.1186/2193-1801-3-309 · Published: June 24, 2014

Simple Explanation

The study developed a laparoscopic method to access the pudendal nerve in pigs for electrode implantation, aiming for chronic neuromodulation studies. The pudendal nerve, rich in sensory fibers, is a target for neuromodulation to treat bladder dysfunctions. Laparoscopic implantation may offer advantages over percutaneous methods, potentially reducing electrode migration risk and ensuring precise placement.

Study Duration

Not specified

Participants

10 female pigs

Evidence Level

Experimental study

Key Findings

1
Laparoscopic access to the pudendal nerve was successfully established in all pigs.
2
Unilateral electrical stimulation of the pudendal nerve did not evoke bladder responses.
3
Histological analysis confirmed the structural integrity of the pudendal nerves after electrode placement.

Research Summary

This study aimed to establish a standardized laparoscopic approach for pudendal nerve localization and electrode implantation in pigs. The laparoscopic technique proved feasible, reproducible, and safe for electrode placement at the pudendal nerve under optical control. Urodynamic measurements during anesthesia are challenging due to the influence of narcotic substances on bladder physiology.

Practical Implications

Alternative Neuromodulation Method

Laparoscopic pudendal neuromodulation can be useful when sacral neuromodulation fails or in cases of anatomical abnormalities.

Targeting Specific Bladder Disorders

Access to peripheral nerves like the pudendal nerve is needed for treating specific bladder disorders that cannot be addressed by S3 modulation alone.

Improved Electrode Placement

Laparoscopy provides better surgical approach for accessing the pudendal nerve and implanting electrodes for chronic neuromodulation.

Study Limitations

1
The tined lead electrodes were inappropriate for laparoscopic handling.
2
Urodynamic measurements were challenging due to the effects of anesthesia on bladder physiology.
3
Acute pudendal nerve stimulation may not accurately reflect the potential effectiveness of chronic stimulation.

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