Functional conditions of micturition induced by selective sacral anterior root stimulation: experimental results in a canine animal model

Abstract

Electrical stimulation of the sacral anterior roots using conventional rectangular current pulses results in a simultaneous contraction of the urinary bladder and the striated urethral sphincter. Using a tripolar nerve cuff electrode with quasitrapezoidal current pulses and appropriate stimulation parameters, hyperpolarization of the nerve-fiber cell membrane under the anode of the stimulating electrode can reversibly arrest action potential propagation in large myelinated nerve fibers, innervating the striated urethral sphincter, while leaving action potential propagation unaffected in small nonmyelinated nerve fibers innervating the urinary bladder smooth muscle (anodal arrest). Using this technique in 19 female mongrel dogs, we studied the effect of bladder filling, level of anesthesia, and sacral deafferentation on bladder pressure, urethral pressure, and urinary flow. Effective micturition could be induced only after complete dorsal rhizotomy, abolishing reflex contraction of the striated urethral sphincter, when blocking quasitrapezoidal current pulses were used for stimulation. Stimulation with rectangular current pulses directly induced a rise in distal urethral pressure, preventing micturition during stimulation.