2002 Fiscal Year Final Research Report Summary
The establishment of a remedy using electrical stimulation and bacterial toxin for pelvic floor muscle dysfunction.
| Project/Area Number |
11671280
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Digestive surgery
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| Research Institution | Jikei University School of Medicine |
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Principal Investigator |
TAKAO Yoshihiko Jikei University School of Medicine, Department of Surgery, Instructor, 医学部, 講師 (50206710)
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| Project Period (FY) |
1999 – 2002
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| Keywords | electrical stimulation / boturinum toxin / fecal incontinence / pelvic floor dysfunction / sphincter denervation / cinedefecQgraphy / blooming effect / spastic pelvic floor syndrome |
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| Research Abstract |
To evaluate feasibility and reliability of electrical stimulation in the treatmentof neuropathic fecal incontinence and boturinum toxin for spastic sphincter using a canine model, the following series of studies "were conducted.
A pilot study performed on 16 dogs to develop an animal model with pudendal neuropathy and neuropathic anal sphincter. The study attempted to crush the pudendal nerve using a hemostat but the sphincter recovered quickly after 2 weeks, and the continuous crush injury using titanium clip showed permanent paralysis. When the absorbable clip applied, the resting pressure once decreased to 56.8% at two weeks compared with the pre-operative value, however it recovered up to 68.3 at the time and has been kept the level thereafter. Therefore, we decided it as a neuropathic sphincter model for the following studies.
An electrical stimulation study was then carried out utilizing five conditioned dog at six weeks after the surgery. The test needle electrode was placed through a sacral notch into the proximal part of caudarectal nerve then stimulated the following setting in order to get the tetanic contraction of the sphincter: amplitude of 1.0V, pulse-width of 210 microsec, and frequency of 25Hz. The resting pressure increased up to 140-150% compared with pre-stimulation level which were more than 90% of pre-operative value. Normal continence activity was confirmed on cinedefecography in the study.
It could not achieved success results on the study of boturinum toxjn injection.Although the resting pressure was decreased enough, the pattern of muscle relaxation were not uniform as expected.
The results of our study strongly suggest that electrical stimulation may play a role in the treatment of neurogenic fecal incontinence. While current procedure classified still invasive, the electrode can be made as a patch type. It should be useful for the aged patient with neurogenic incontinence.
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Research Products
(4 results)
