腹部、耳朵和胫骨神经的经皮电刺激调节大鼠逼尿肌过度活动模型中的膀胱收缩:一项初步研究。

IF 1.8 3区 医学 Q3 UROLOGY & NEPHROLOGY
International Neurourology Journal Pub Date : 2023-09-01 Epub Date: 2023-09-30 DOI:10.5213/inj.2346144.072
Rosa L Coolen, Dennis Frings, Els van Asselt, Jeroen R Scheepe, Bertil F M Blok
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引用次数: 0

摘要

目的:膀胱过度活动症(OAB)的全球患病率估计为11.8%。尽管有骶骨神经调控等现有治疗方案,但仍有大量患者未得到治疗。一种潜在的替代方案是非侵入性经皮电刺激。这种形式的刺激不需要植入电极,从而消除了对高技能外科医生、昂贵的植入式设备或定期医院就诊的需求。我们假设替代神经通路可以影响膀胱收缩。方法:在这项初步研究中,我们对3只麻醉雌性Sprague-Dawley大鼠的腹壁(T6-L1)、耳朵(迷走神经)和脚踝(胫神经)进行了经皮电刺激。在20赫兹至20千赫的范围内给予刺激,并测量其对膀胱内压力的影响。我们重点研究了与膀胱内压力相关的3个主要结果:(1)从收缩开始到达到峰值的压力变化,(2)收缩的平均持续时间,以及(3)特定时间段内的收缩次数。这些测量是在膀胱充满盐水或乙酸(作为OAB的模型)时进行的。结果:在输注乙酸期间,以20Hz的频率经皮刺激腹壁、耳朵和脚踝可以减少膀胱收缩的次数。通过比较膀胱输注乙酸过程中胫神经的各种刺激频率,发现在1kHz和3kHz的刺激下,与在20Hz的刺激相比,收缩持续时间明显更短(分别为P=0.025和P=0.044),与经皮胫骨神经刺激和骶骨神经调控相比,胫骨神经可以为OAB提供侵入性较小且更具成本效益的治疗选择。建议进行更大样本量的后续研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Transcutaneous Electrical Stimulation of the Abdomen, Ear, and Tibial Nerve Modulates Bladder Contraction in a Rat Detrusor Overactivity Model: A Pilot Study.

Transcutaneous Electrical Stimulation of the Abdomen, Ear, and Tibial Nerve Modulates Bladder Contraction in a Rat Detrusor Overactivity Model: A Pilot Study.

Transcutaneous Electrical Stimulation of the Abdomen, Ear, and Tibial Nerve Modulates Bladder Contraction in a Rat Detrusor Overactivity Model: A Pilot Study.

Transcutaneous Electrical Stimulation of the Abdomen, Ear, and Tibial Nerve Modulates Bladder Contraction in a Rat Detrusor Overactivity Model: A Pilot Study.

Purpose: The global prevalence of overactive bladder (OAB) is estimated at 11.8%. Despite existing treatment options such as sacral neuromodulation, a substantial number of patients remain untreated. One potential alternative is noninvasive transcutaneous electrical stimulation. This form of stimulation does not necessitate the implantation of an electrode, thereby eliminating the need for highly skilled surgeons, expensive implantable devices, or regular hospital visits. We hypothesized that alternative neural pathways can impact bladder contraction.

Methods: In this pilot study, we conducted transcutaneous electrical stimulation of the abdominal wall (T6-L1), the ear (vagus nerve), and the ankle (tibial nerve) of 3 anesthetized female Sprague-Dawley rats. Stimulation was administered within a range of 20 Hz to 20 kHz, and its impact on intravesical pressure was measured. We focused on 3 primary outcomes related to intravesical pressure: (1) the pressure change from the onset of a contraction to its peak, (2) the average duration of contraction, and (3) the number of contractions within a specified timeframe. These measurements were taken while the bladder was filled with either saline or acetic acid (serving as a model for OAB).

Results: Transcutaneous stimulation of the abdominal wall, ear, and ankle at a frequency of 20 Hz decreased the number of bladder contractions during infusion with acetic acid. As revealed by a comparison of various stimulation frequencies of the tibial nerve during bladder infusion with acetic acid, the duration of contraction was significantly shorter during stimulation at 1 kHz and 3 kHz relative to stimulation at 20 Hz (P = 0.025 and P = 0.044, respectively).

Conclusion: The application of transcutaneous electrical stimulation to the abdominal wall, ear, and tibial nerve could provide less invasive and more cost-effective treatment options for OAB relative to percutaneous tibial nerve stimulation and sacral neuromodulation. A follow-up study involving a larger sample size is recommended.

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来源期刊
International Neurourology Journal
International Neurourology Journal UROLOGY & NEPHROLOGY-
CiteScore
4.40
自引率
21.70%
发文量
41
审稿时长
4 weeks
期刊介绍: The International Neurourology Journal (Int Neurourol J, INJ) is a quarterly international journal that publishes high-quality research papers that provide the most significant and promising achievements in the fields of clinical neurourology and fundamental science. Specifically, fundamental science includes the most influential research papers from all fields of science and technology, revolutionizing what physicians and researchers practicing the art of neurourology worldwide know. Thus, we welcome valuable basic research articles to introduce cutting-edge translational research of fundamental sciences to clinical neurourology. In the editorials, urologists will present their perspectives on these articles. The original mission statement of the INJ was published on October 12, 1997. INJ provides authors a fast review of their work and makes a decision in an average of three to four weeks of receiving submissions. If accepted, articles are posted online in fully citable form. Supplementary issues will be published interim to quarterlies, as necessary, to fully allow berth to accept and publish relevant articles.
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