Karl-Erik Andersson led the peer-review process as the Associate Editor responsible for the paper.
Combination of foot stimulation and tolterodine treatment eliminates bladder overactivity in cats
Version of Record online: 29 AUG 2013
© 2013 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 33, Issue 8, pages 1266–1271, November 2014
How to Cite
Schwen, Z., Matsuta, Y., Shen, B., Wang, J., Roppolo, J. R., de Groat, W. C. and Tai, C. (2014), Combination of foot stimulation and tolterodine treatment eliminates bladder overactivity in cats. Neurourol. Urodyn., 33: 1266–1271. doi: 10.1002/nau.22479
- Issue online: 13 OCT 2014
- Version of Record online: 29 AUG 2013
- Manuscript Accepted: 16 JUL 2013
- Manuscript Received: 29 MAY 2013
- National Institutes of Health. Grant Numbers: DK094905, DK-068566, DK-090006, DK-091253
- overactive bladder;
To determine whether transcutaneous foot stimulation combined with a lower dose tolterodine would inhibit bladder overactivity more effectively than either treatment alone.
Cystometrograms were performed on α-chloralose anesthetized cats (N = 6) by infusing 0.25% acetic acid (AA) to induce bladder overactivity. Foot stimulation (5 Hz) was applied at 2 and 4 times the threshold (T) intensity in volts (i.e., 2T or 4T) for inducing toe movement to inhibit bladder overactivity. Cumulative doses of tolterodine (0.003–0.3 mg/kg, i.v.) were also administered to determine the effect of combination treatment.
AA irritation of the bladder significantly (P < 0.0001) reduced bladder capacity to 23.6 ± 7.1% of saline control capacity. Foot stimulation alone at 2T and 4T inhibited bladder overactivity and significantly (P < 0.0001) increased bladder capacity to 50.7 ± 6.8% and 79.0 ± 11.6% of saline control, respectively. Tolterodine alone at 0.3 mg/kg significantly (P < 0.05) increased bladder capacity to 65.6 ± 15.5% of saline control. However, when tolterodine at a threshold dose (0.3 mg/kg) was combined with foot stimulation, the bladder capacity was significantly (P < 0.05) increased to 86.2 ± 6.2% and 107.9 ± 10.6% by 2T and 4T stimulation, respectively. Complete inhibition of bladder overactivity could be achieved at a lower tolterodine dose (0.1 mg/kg) when combined with 4T stimulation (97.0 ± 11.2% of saline control). The amplitude of micturition contraction was not changed by tolterodine treatment.
This study suggests a novel, efficacious, non-invasive therapy by combining foot stimulation with a lower dose tolterodine to treat bladder overactivity. It also provides the first objective evidence supporting an additive therapeutic benefit of neuromodulation and antimuscarinic combination treatment. Neurourol. Urodynam. 33:1266–1271, 2014. © 2013 Wiley Periodicals, Inc.