Dirk De Ridder led the peer-review process as the Associate Editor responsible for the paper.
Does patterned afferent stimulation of sacral dermatomes suppress urethral sphincter reflexes in individuals with spinal cord injury?
Version of Record online: 9 FEB 2014
© 2014 Wiley Periodicals, Inc.
Neurourology and Urodynamics
Volume 34, Issue 3, pages 219–223, March 2015
How to Cite
McCoin, J. L., Bhadra, N., Brose, S. W. and Gustafson, K. J. (2015), Does patterned afferent stimulation of sacral dermatomes suppress urethral sphincter reflexes in individuals with spinal cord injury?. Neurourol. Urodyn., 34: 219–223. doi: 10.1002/nau.22545
- Issue online: 12 MAR 2015
- Version of Record online: 9 FEB 2014
- Manuscript Accepted: 15 NOV 2013
- Manuscript Received: 11 JUN 2013
- National Institute of Health. Grant Numbers: DK077089, EB004314
- Department of Veterans Affairs. Grant Number: RR&D6685
- The Cleveland FES Center
- neurogenic bladder;
- functional electrical stimulation;
- afferent stimulation;
- voiding dysfunction;
- detrusor sphincter dyssynergia
Dyssynergic contractions of the external urethral sphincter prevent efficient bladder voiding and lead to numerous health concerns. Patterned electrical stimulation of the sacral dermatomes reduces urethral sphincter spasms and allows functional bladder emptying in cats after chronic SCI. Reflex suppression in animals is strongly dependent on stimulus location and pattern. The purpose of this study was to determine whether the stimulation patterns and locations effective in animals suppress urethral sphincter spasms in humans with SCI.
Ten subjects with chronic SCI underwent bladder filling to elicit distention-evoked contractions. During reflex contractions patterned electrical stimulation was applied to the S2 or S3 dermatome in random 25-sec intervals. Bladder and sphincter pressures were simultaneously recorded and compared between control and afferent stimulation periods.
Six of the 10 subjects demonstrated both reflex bladder and sphincter contractions with bladder filling. No significant reduction in urethral pressure was observed during stimulation for any stimulus locations and patterns tested.
Stimulation parameters and locations effective in SCI animals did not suppress reflex sphincter activity in these human subjects. It is likely that a broader set of stimulus patterns and dermatome locations will need to be tested to find the effective combination in humans. Neurourol. Urodynam. 34:219–223, 2015. © 2014 Wiley Periodicals, Inc.