Pudendal nerve stimulation is a promising treatment approach for lower urinary tract dysfunction, including symptoms of overactive bladder. Despite some promising clinical studies, there remain many unknowns as to how best to stimulate the pudendal nerve to maximize therapeutic efficacy. We quantified changes in bladder capacity and voiding efficiency during single-fill cystometry in response to electrical stimulation of the sensory branch of the pudendal nerve in urethane-anesthetized female Wistar rats. Increases in bladder capacity were dependent on both stimulation amplitude and rate. Stimulation that produced increases in bladder capacity also led to reductions in voiding efficiency. As well, there was a stimulation carryover effect and increases in bladder capacity persisted during several non-stimulated trials following stimulated trials. Intravesically administered Prostaglandin E2 reduced bladder capacity, producing a model of OAB, and sensory pudendal nerve stimulation again increased bladder capacity but also reduced voiding efficiency. This study serves as a basis for future studies seeking to maximize the therapeutic efficacy of sensory pudendal nerve stimulation for the symptoms of OAB.
American journal of physiology. Renal physiology. 2017 Nov 15 [Epub ahead of print]
James A Hokanson, Christopher L Langdale, Arun Sridhar, Warren M Grill
Duke University., GlaxoSmithKline., Duke University .