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Pudendal neuromodulation improves voiding efficiency in diabetic rats§

Authors

  • Shih-Ching Chen,

    1. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
    2. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
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  • Chien-Hung Lai,

    1. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
    2. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
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  • Wen-Jia Fan,

    1. Department and Institute of Physiology, National Yang-Ming University, Taipei, Taiwan
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  • Chih-Wei Peng

    Corresponding author
    1. Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
    2. Department of Physical Medicine and Rehabilitation, Taipei Medical University Hospital, Taipei, Taiwan
    3. Neuroscience Research Center, Taipei Medical University Hospital, Taipei, Taiwan
    • Department of Physical Medicine and Rehabilitation, School of Medicine, College of Medicine, Taipei Medical University, 250 Wuxing Street, Taipei 11031, Taiwan.
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  • Lori Birder led the peer-review process as the Associate Editor responsible for the paper.

  • Conflicts of interest: none.

  • §

    Shih-Ching Chen, Chien-Hung Lai contributed equally to this work and should be considered as first authors.

Abstract

Aims

Diabetic cystopathy is typically manifested as bladder voiding dysfunction, and numerous patients are refractory to standard therapy. In this study, we determined whether electrical stimulation (ES) of the sensory branch of the pudendal nerve could engage an augmenting reflex and thereby improve bladder emptying in a diabetic animal model with cystopathy.

Methods

The efficiency of bladder emptying with ES of the sensory branch of the pudendal nerve at different stimulation intensities was measured in rats at 8 or 18 weeks after the induction of diabetes with streptozotocin.

Results

The voiding efficiency (VE) was reduced from 74 ± 4% to 30 ± 8% in rats with diabetes for 8 weeks and from 73 ± 6% to 20 ± 6% in rats with diabetes for 18 weeks. ES at lower intensities (0.025–0.05 mA) applied to the pudendal sensory nerve did not affect the VE in rats with diabetes for 18 weeks but increased the VE in rats with diabetes for 8 weeks. Subsequently, when the stimulation intensity was elevated to 0.1–0.3 mA, the VEs in rats with diabetes for both 8 and 18 weeks increased to 40–50%.

Conclusions

The results of the present study are consistent with the essential role for pudendal sensory feedback in efficient bladder emptying, and electrical activation of the sensory branch of the pudendal nerve was efficient restoring the voiding function in diabetic animals with cystopathy. This could provide an approach to improve bladder emptying in diabetic patients with voiding dysfunction. Neurourol. Urodynam. 32: 293–300, 2013. © 2012 Wiley Periodicals, Inc.

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