INTRODUCTION: Sacral neuromodulation (SNM) is an effective treatment modality for several urological problems, including neurogenic bladder.
However, the invasiveness of this technique makes it unsuitable for many patients. We present a novel transdermal amplitude-modulated signal (TAMS) that may provide a non-invasive alternative to implantable SNM to treat neurogenic detrusor overactivity (NDO).
INTRODUCTION: METHODS:In this study, we investigated the mechanism of action of non-invasive SNM using TAMS on our established spinal cord injury (SCI) animal model. We demonstrated that spinally transected rats develop urinary bladder hyper-reflexia after 3 weeks of SCI, indicated by the presence of uninhibited contractions, increased resting pressure, increased threshold pressure and increased maximum voiding pressure.
RESULTS: Short-term neurostimulation affected urodynamics parameters by significantly reducing the threshold pressure (p = 0.02). Spinal transection also increased calcitonin gene-related protein (CGRP) concentration in the L6 dorsal root ganglia; whereas, neurostimulation significantly reduced CGRP concentration in L6 (p = 0.03).
CONCLUSION: TAMS caused a reduction in NDO by inhibiting C-fibre activity.
Written by:
Elkelini MS, Pravdivyi I, Hassouna MM. Are you the author?
Toronto Western Research Institute, Toronto, ON; Institute of Medical Science, University of Toronto and Department of Surgery, Division of Urology, University of Toronto, Toronto, ON.
Reference: Can Urol Assoc J. 2012 Aug;6(4):227-30.
doi: 10.5489/cuaj.11249
PubMed Abstract
PMID: 23093526
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