| Summary: | 碩士 === 臺灣大學 === 生醫電子與資訊學研究所 === 98 === Spinal cord injured (SCI) patients often accompanied detrusor-EUS dyssynergia (DSD) who have low efficiency of micturition function and incomplete voiding, and increase the risk of urinary tract infection. Long-term period under this situation will cause ureteral edema, renal damage, and even renal failure.
Functional electrical stimulation is a new treatment direction for replacement of the permanent nerve damage to improve the voiding function in neurogenic bladder. In our study, micro-side opened cuff electrode was placed on the pudendal nerve in SCI rats. Low amplitude (~0.03mA) of low frequency stimulation (LFS) delivered on the unilateral sensory branch of the pudendal nerve significantly increased the voiding efficiency from 10% to 30% in SCI animals. However, high amplitude current (~0.2mA) inhibited the bladder emptying. On the other hand, high frequency blocking (HFB, 10 kHz or 20 kHz) applied on the bilateral motor branches of the pudendal nerve relaxed the EUS. After applying HFB on the motor branch, the cystometrogram (CMG) would recover back to control CMG pattern. Therefore, the HFB current did not likely cause dramatic neural damage. The simultaneous applications of LFS and HFB on the unilateral pudendal nerve also dramatically increased the voiding efficiency up to 30~40%. However, the unilateral motor branch with applying HFB was likely ineffective to inprove bladder emptying.
In this study, the LFS combined with the HFB technique was successful to modulate the bladder voiding function in SCI rats. In the future, we should further to investigate the pudendal nerve activity during voiding cycle to establish a mimic model of voiding pattern, and the results integrating our current results would produce a more efficient voiding.
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