Research Abstract |
Electrical pelvic floor stimulation using a percutaneous procedure was carried out on 13 patients suffering from urinary incontinence due to overactive detrusor function. After the percutaneous electrode implantation, chronic stimulation was carried out employing portable external electrical stimulator which we developed. 4 to 16 weeks of maximal electrical stimulation improved urinary incontinence in 10 of 13 patients. In 2 of these 10 patients, incontinence disappeared subjectively. Urodynamic investigations demonstrated a increased volume at first unstable contraction in all patients. Inhibition of detrusor overactivity was obtained from this procedure. The stimulation appeared to be constant during chronic stimulation. This procedure can provide stable and reliable stimulation for chronic treatment and can be an alternative for the treatment of urinary incontinence. [Int.Urol.Nephrol., 24 : 277-282, 1992, Eur.Urol., 23 : 413-416, 1993, Frontiers Med.Biol.Engig., 5 : 1-10, 1993, Br.J.Urol., 1994 in press.] We also investigated the basic mechanism of the pelvic floor stimulation. Experiments were carried out to evaluate the regional norepinephrine (NE) content of the rabbit bladder. Content of NE increased in both the bladder base and body significantly after the acute electrical pelvic floor stimulation. Increased NE content sustained 1 to 2 hours after ceasing the stimulation. Based on these findings, during EPFS the hypogastric nerve would play a significant role in bladder inhibition. [J.Urol., 150 : 235-238, 1993, J.Urol., 151 : 774-775, 1994.]
|