Restoring both continence and micturition after chronic spinal cord injury by pudendal neuromodulation

Guo, Wenbin; Shapiro, Katherine; Wang, Zhaoxia; Armann, Kody; Shen, Bing; Wang, Jicheng; Roppolo, James R.; Groat, William C. de; Tai, Changfeng

doi:10.1016/j.expneurol.2021.113658

Cited by 17 publications

(7 citation statements)

References 25 publications

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“…NLUTD has been investigated in a variety of animal models of SCI, with the majority of studies inducing the SCI in the thoracic spine by complete transection, but with other injury mechanisms such as contusion, compression and heat ablation also described (Figure 1). While cats and dogs were commonly utilized in the first investigations into the basic neural mechanisms underlying LUT function in the late 19th century [47] and late 1960-1970s [48][49][50][51], more recent studies focusing on NLUTD after SCI have been performed using rats [36,40,44,52,, mice [35,[116][117][118][119][120][121][122], cats [29,30,32,33,48,[123][124][125][126][127][128][129][130][131][132][133][134][135][136], dogs [44,51,[137][138][139][140], and pigs [31,141] (Table…”

Section: Cystometric Findings In Animal Models Of Scimentioning

confidence: 99%

“… [ 32 ] T9-T10 Suprapubic 6–8 weeks α-chloralose [ 133 ] T9-T10 Transurethral 18–24 weeks [ 30 ] T9-T10 Transurethral 4–5 weeks α-chloralose [ 134 ] T9-T10 Transurethral 4–50 weeks α-chloralose [ 135 ] Transection/Contusion T8 Transurethral 3 weeks Ketamine/Xylazine. [ 136 ] Dog Transection T10 Suprapubic/Transurethral 1–4 weeks Halothane [ 51 ] T10 Transurethral 1–8 months Not specified [ 137 ] …”

Section: Cystometric Findings In Animal Models Of Scimentioning

confidence: 99%

“…Historically, cats were among the first species to have their LUT function characterized after SCI and remain a relatively common model for NLUTD, partly due to their large bladder size relative to rodents. Transurethral [ 133 , 134 , 135 , 136 ] and suprapubic [ 30 , 32 , 33 , 131 , 132 ] approaches are commonly used to evaluate bladder function in these animals. Under normal conditions, EUS function during storage and voiding in felines more closely resembles human EUS EMG relaxation–contraction such that EUS activity is largely silenced during micturition [ 183 ].…”

Section: Cystometric Findings In Animal Models Of Scimentioning

confidence: 99%

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Assessing Neurogenic Lower Urinary Tract Dysfunction after Spinal Cord Injury: Animal Models in Preclinical Neuro-Urology Research

et al. 2023

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Neurogenic bladder dysfunction is a condition that affects both bladder storage and voiding function and remains one of the leading causes of morbidity after spinal cord injury (SCI). The vast majority of individuals with severe SCI develop neurogenic lower urinary tract dysfunction (NLUTD), with symptoms ranging from neurogenic detrusor overactivity, detrusor sphincter dyssynergia, or sphincter underactivity depending on the location and extent of the spinal lesion. Animal models are critical to our fundamental understanding of lower urinary tract function and its dysfunction after SCI, in addition to providing a platform for the assessment of potential therapies. Given the need to develop and evaluate novel assessment tools, as well as therapeutic approaches in animal models of SCI prior to human translation, urodynamics assessment techniques have been implemented to measure NLUTD function in a variety of animals, including rats, mice, cats, dogs and pigs. In this narrative review, we summarize the literature on the use of animal models for cystometry testing in the assessment of SCI-related NLUTD. We also discuss the advantages and disadvantages of various animal models, and opportunities for future research.

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Section: Cystometric Findings In Animal Models Of Scimentioning

confidence: 99%

Section: Cystometric Findings In Animal Models Of Scimentioning

confidence: 99%

Section: Cystometric Findings In Animal Models Of Scimentioning

confidence: 99%

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Assessing Neurogenic Lower Urinary Tract Dysfunction after Spinal Cord Injury: Animal Models in Preclinical Neuro-Urology Research

et al. 2023

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“…Urethrocystoscopy should be used to evaluate the lower urinary tract in persons with NLUTD who have concomitant hematuria, recurrent UTIs, suspected anatomic anomaly or stones, but not routinely performed as screening or surveillance [ 15 ]. Although patients with a history of SCI and chronic indwelling catheter use have been shown to have a higher risk of developing bladder cancer in some studies [ 26 , 27 ], recent systematic reviews have demonstrated that cystoscopy and cytology are poor screening tests for bladder cancer in NLUTD, and those without signs and symptoms listed above should not routinely be screened [ 15 , 28 , 29 ].…”

Section: Invasive Testingmentioning

confidence: 99%

Neurogenic Bladder Physiology, Pathogenesis, and Management after Spinal Cord Injury

Perez

Godbole

Amin

et al. 2022

JPM

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Urinary incontinence is common after spinal cord injury (SCI) due to loss of supraspinal coordination and unabated reflexes in both autonomic and somatic nervous systems; if unchecked, these disturbances can become life-threatening. This manuscript will review normal anatomy and physiology of the urinary system and discuss pathophysiology secondary to SCI. This includes a discussion of autonomic dysreflexia, as well as its diagnosis and management. The kidneys and the ureters, representing the upper urinary tract system, can be at risk related to dyssynergy between the urethral sphincters and high pressures that lead to potential vesicoureteral reflux, urinary tract infections, and calculi associated with neurogenic lower urinary tract dysfunction (NLUTD). Recent guidelines for diagnosis, evaluation, treatment and follow up of the neurogenic bladder will be reviewed and options provided for risk stratification and management. Mechanical, pharmacological, neurolysis and surgical management will be discussed.

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“…Functional electrical stimulation (FES) shows promise for the management of patients with OAB and preventing urinary incontinence [4][5][6][7][8] . Several studies have shown that electrical stimulation applied to the pudendal nerve [9][10][11][12][13] , sacral roots 14 , sacral dorsal root ganglion (DRG) 15,16 , and pelvic nerve 17,18 , at certain frequencies can inhibit bladder hyperreflexia, maintain continence, and increase the bladder capacity. In these studies, the inhibitory pathways were stimulated continuously, and habituation in response to continuous stimulation may affect the effectiveness of bladder inhibition 19,20 .…”

Section: Introductionmentioning

confidence: 99%

Real-time prediction of bladder urine leakage using fuzzy inference system and dual Kalman filtering in cats

Qasemi,

Aminian,

Erfanian

2023

Preprint

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The use of electrical stimulation devices to manage bladder incontinence relies on the application of continuous inhibitory stimulation. However, continuous stimulation can result in tissue fatigue and increased delivered charge. Here, we employ a real-time algorithm to provide a short-time prediction of urine leakage using the high-resolution power spectrum of the bladder pressure during the presence of non-voiding contractions (NVC) in normal and overactive bladder (OAB) cats. The proposed method is threshold-free and does not require pre-training. The analysis revealed that there is a significant difference between voiding contraction (VC) and NVC pressures as well as band powers (0.5-5 Hz) during both normal and OAB conditions. Also, most of the first leakage points occurred after the maximum VC pressure, while all of them were observed subsequent to the maximum VC spectral power. Kalman-Fuzzy method predicted urine leakage on average 2.17 s and 1.64 s before its occurrence and an average of 1.96 s and 1.13 s after the contraction started in normal and OAB cats, respectively, with a 100% success rate. This work presents a promising approach for developing a neuroprosthesis device, with on-demand stimulation to control bladder incontinence.

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Restoring both continence and micturition after chronic spinal cord injury by pudendal neuromodulation

Cited by 17 publications

References 25 publications

Assessing Neurogenic Lower Urinary Tract Dysfunction after Spinal Cord Injury: Animal Models in Preclinical Neuro-Urology Research

Assessing Neurogenic Lower Urinary Tract Dysfunction after Spinal Cord Injury: Animal Models in Preclinical Neuro-Urology Research

Neurogenic Bladder Physiology, Pathogenesis, and Management after Spinal Cord Injury

Real-time prediction of bladder urine leakage using fuzzy inference system and dual Kalman filtering in cats

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