Detrusor and blood pressure responses to dorsal penile nerve stimulation during hyperreflexic contraction of the bladder in patients with cervical cord injury.
OBJECTIVE
To investigate the immediate effect of dorsal penile nerve (DPN) stimulation on detrusor pressure (P(det)) and blood pressure during hyperreflexic contractions of the bladder in patients with cervical spinal cord injury (SCI).


METHODS
Blood pressure and P(det) monitoring during cystometry with and without DPN stimulation.


METHODS
Urodynamic laboratory in a university hospital in Korea.


METHODS
Eight men (age range, 20-55y) with cervical SCI that was incurred from 4 months to 10 years before this study.


METHODS
During water cystometry, blood pressure was monitored with an intra-arterial catheter introduced percutaneously into the radial artery and was recorded simultaneously with the P(det). Blood pressure was also measured manually with an electronic blood pressure cuff. Electric stimulation was applied to the DPN by using surface electrodes each time a bladder contraction was detected. Stimulation intensity was twice the threshold of the pudendal-anal reflex.


METHODS
P(det), systolic blood pressure, and diastolic blood pressure.


RESULTS
As P(det) increased, the blood pressure increased in all cases. All the reflex contractions of the bladder were effectively suppressed by DPN stimulation, and as the P(det) decreased during stimulation, radial arterial pressure also decreased immediately and significantly.


CONCLUSIONS
DPN stimulation can decrease P(det) and the increased blood pressure associated with it.
Lee
Young-Hee
YH
Department of Rehabilitation Medicine, Wonju Christian Hospital, Wonju, Korea. lee02@wonju.yonsei.ac.kr
Creasey
Graham H
GH
Lim
Hyunkyo
H
Song
Jaemann
J
Song
Kihak
K
Kim
Jinweon
J
D000328:Adult; D020211:Autonomic Dysreflexia / Q000503:physiopathology*; D001794:Blood Pressure; D004599:Electric Stimulation Therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010413:Penis / Q000294:innervation; D013119:Spinal Cord Injuries / Q000503:physiopathology*; D001743:Urinary Bladder / Q000503:physiopathology*; D001750:Urinary Bladder, Neurogenic / Q000503:physiopathology; D014563:Urodynamics