Mapping and neuromodulation of lower urinary tract function using spinal cord stimulation in female rats

Exp Neurol, 2018 · DOI: 10.1016/j.expneurol.2018.03.007 · Published: July 1, 2018

Simple Explanation

Spinal cord stimulation (SCS) is a technology used to manage spasticity and pain, and is being explored as a way to help with movement and urination after spinal cord injury. This study uses SCS in rats to understand how it affects the muscles controlling urination. Specifically, it looks at how stimulating different parts of the spinal cord impacts the external urethral sphincter (EUS), which is important for bladder control. The study found that SCS at a specific location (L3) can help improve bladder emptying after nerve damage. This suggests that SCS could be a potential treatment for underactive bladder, a condition where the bladder doesn't empty properly.

Study Duration

14 days post-operatively

Participants

19 adult female Sprague-Dawley rats

Evidence Level

Not specified

Key Findings

1
SCS of L2-3 inhibited EUS tonic activity, and SCS on L3 (L3/SCS) inhibited EUS tonic activity and elicited EUS bursting.
2
The PNC injury resulted in decreased voiding efficiency and maximum intravesical pressure, whereas the post-voiding residual volume was increased, suggestive of an underactive bladder.
3
Voiding efficiency was significantly increased, and the residual volume was decreased by L3/SCS in rats after the PNC injury.

Research Summary

The study mapped the effects of spinal cord stimulation (SCS) on the lower urinary tract (LUT) in rats, finding that stimulation of different lumbar segments had distinct effects on the external urethral sphincter (EUS). A pelvic nerve crush (PNC) injury was found to induce an underactive bladder condition in rats, characterized by decreased voiding efficiency and increased residual volume. L3 spinal cord stimulation (L3/SCS) was shown to improve voiding efficiency and reduce residual volume in rats with PNC injury, suggesting a potential therapeutic application for neurogenic underactive bladder.

Practical Implications

Targeted Therapy

SCS at L3 could be a potential therapy for underactive bladder.

Continence Treatment

SCS applied to L1, L4-L6 may provide an opportunity to increase urethral resistance during periods of increased bladder pressure to promote continence.

Mimicking Neurogenic Bladder

PNC animal model mimics symptoms of neurogenic underactive bladder, to use for future studies.

Study Limitations

1
The study was conducted on female rats, and the results may not be directly applicable to humans or males.
2
The study focused on a specific type of nerve injury (PNC), and the effects of SCS may vary depending on the cause and severity of bladder dysfunction.
3
The long-term effects of L3/SCS on LUT function and potential side effects were not investigated.

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