Electrical stimulation of somatic afferent nerves in the foot increases bladder capacity in neurogenic bladder patients after sigmoid cystoplasty

Abstract

BackgroundA previous study showed that foot stimulation can delay the bladder filling sensation and increase bladder volume in healthy humans without OAB. The aim of this study was to determine whether or not electrical stimulation of somatic afferent nerves in the foot can increase bladder capacity in neurogenic bladder patients after sigmoid cystoplasty.MethodsEleven subjects underwent 30-min foot stimulation using skin surface electrodes connected to a bladder-pelvic stimulator. The electrodes were attached to the bottom of the foot. The subjects completed a 5-day voiding diary, during which time foot stimulation was applied on day 3. The stimulation parameter was a continuous, bi-polar square wave form with a pulse duration of 200 μs and a stimulation frequency of 5 Hz. The stimulation intensity was set by each subject at a maximal level without causing discomfort.ResultsThe volume per clean intermittent catheterization (CIC) was 279.4 ± 11.7 ml and 285.4 ± 11.8 ml on the 1st and 2nd days, respectively. On the 3rd day, the average volume per CIC increased to 361.1 ± 18.1 ml after stimulation (p <0.05). The average volume per CIC returned to 295.4 ± 13.4 ml and 275.1 ± 11.5 ml on the 4th and 5th days, respectively.ConclusionsFoot stimulation can delay the bladder filling sensation and significantly increase bladder capacity in neurogenic bladder patients after sigmoid cystoplasty.

Increasing bladder capacity by foot stimulation in rats with spinal cord injuries

“…In our previous study [ 8 ], we found that foot stimulation delayed the bladder filling sensation and significantly increased BC in the patients after bladder augmentation. Comparing with baseline, the volume per CIC was significantly increased, and this long-lasting effect persisted nearly 1 day.…”

“…The mechanism underlying foot stimulation is unknown, but may be mediated by the nerves in the foot [ 6 – 8 ]. The stimulation electrodes were placed on the skin surface rather than directly on the nerves.…”

“…Stimulation of the foot using skin surface electrodes is a new, non-invasive, easily accessible, convenient way to inhibit bladder activity and increase bladder capacity, which has been verified in cats with overactive bladders [ 6 ] and healthy humans [ 7 ]. In our previous study, we reported that electrical stimulation of somatic afferent nerves in the feet can increase bladder capacity in patients with neurogenic bladders after sigmoid cystoplasty [ 8 ]. Although a positive effect was shown in those patients, we need to do further research in patients with other types of neurogenic bladder.…”

Evaluation and Management of Neurogenic Bladder: What Is New in China?

“…We completed a study to determine whether or not electrical stimulation of somatic afferent nerves in the foot can increase bladder capacity in patients with NB after sigmoid cystoplasty. We showed that the bladder volume was increased from 279.4 to 361.1 mL after stimulation using the Bladder-Pelvic Stimulator [ 41 ]. A branch of the tibial nerve courses through the foot, which likely explains this effect.…”

Characterizing the transcutaneous electrical recruitment of lower leg afferents in healthy adults: implications for non-invasive treatment of overactive bladder

“…As a potential solution for improving the clinical efficacy, we have begun to investigate the feasibility of using TENS to electrically activate multiple nerve targets. Bladder-inhibitory responses evoked by TN stimulation is a well-documented phenomenon that has been demonstrated in anesthetized animals [ 14 – 16 ], and also in human participants subjected to surface stimulation of the plantar surface of the foot [ 17 , 18 ]. It has also been shown in anesthetized rats that electrical stimulation of the medial and lateral plantar nerves can evoke reflexes that (1) inhibit the bladder during electrical stimulation (i.e.…”