Superficial peroneal neuromodulation of nonobstructive urinary retention in cats.

Abstract

AIMS: To determine if superficial peroneal nerve stimulation (SPNS) can improve nonobstructive urinary retention (NOUR). METHODS: In &#x3b1;-chloralose anesthetized cats, NOUR was induced by repetitive application (4-16 times) of 30-minute tibial nerve stimulation (TNS: 5&#x2009;Hz frequency, 0.2&#x2009;ms pulse width) at 4 to 6 times threshold intensity (T) for inducing toe twitches. SPNS (1&#x2009;Hz, 0.2&#x2009;ms) at 2 to 4 times threshold intensity (T) for inducing posterior thigh muscle contractions was applied either continuously (SPNSc) during a cystometrogram (CMG) or during voiding (SPNSv) by a surgically implanted cuff electrode or by skin surface electrodes to determine if the stimulation reduced NOUR induced by prolonged TNS. RESULTS: During control CMGs, efficient (86.4%&#x2009;&#xb1;&#x2009;5.5%) voiding occurred with a postvoid residual (PVR) volume equal to 14.9%&#x2009;&#xb1;&#x2009;6.2% of control bladder capacity. NOUR elicited by prolonged TNS significantly (P&#x2009;<&#x2009;.05) increased bladder capacity to 168.6%&#x2009;&#xb1;&#x2009;15.5% of control, reduced voiding efficiency to 30.4%&#x2009;&#xb1;&#x2009;4.8%, and increased PVR to 109%&#x2009;&#xb1;&#x2009;9.2% of control. Using the implanted cuff electrode, SPNSc and SPNSv significantly (P&#x2009;<&#x2009;.05) increased voiding efficiency to 66.7%&#x2009;&#xb1;&#x2009;7.4% and 65.0%&#x2009;&#xb1;&#x2009;5.9%, respectively, and reduced PVR to 52.2%&#x2009;&#xb1;&#x2009;11.4% and 64.3%&#x2009;&#xb1;&#x2009;11.6%, respectively. SPNSc but not SPNSv significantly (P&#x2009;<&#x2009;.05) reduced bladder capacity to 133.4%&#x2009;&#xb1;&#x2009;15% of control. Transcutaneous SPNSv but not SPNSc also significantly (P&#x2009;<&#x2009;.05) reversed the TNS-induced NOUR responses. CONCLUSIONS: This study shows that SPNS is effective in reversing NOUR induced by prolonged TNS. Transcutaneous SPNS provides the opportunity to develop a noninvasive neuromodulation therapy for NOUR to treat more patients than current sacral neuromodulation therapy.