title: Suppression of bladder overactivity by activation of somatic afferent nerves in the foot.
abstract: OBJECTIVE
  To investigate the possibility of suppressing bladder overactivity by electrical activation of somatic afferent nerves in the foot.
  
  
  METHODS
  Cats with an intact spinal cord were studied under α-chloralose anaesthesia. Bladder pressure was recorded via a urethral catheter. Foot stimulation was applied via surface pad electrodes attached to the skin of the front or hind foot.
  
  
  RESULTS
  Reflex micturition was inhibited by electrical stimulation of the hind foot at either low (5 Hz) or high (20 Hz) frequencies, but stimulation of the front foot was ineffective. The mean (sem) bladder capacity during a saline infusion cystometrogram (CMG) was significantly (P < 0.05) increased to 153.2 (18.2)% and 136.9 (14.3)% of the control bladder capacity by stimulation at frequencies of 5 Hz and 20 Hz, respectively. Intravesical infusion of 0.25% acetic acid (AA) induced bladder overactivity and reduced bladder capacity to 20.3 (8.9)% of the control capacity measured during saline infusion. Foot stimulation inhibited the AA-induced bladder overactivity recorded under isovolumetric conditions, and significantly (P < 0.05) increased bladder capacity during AA infusion. However, it only restored the small bladder capacity caused by AA irritation to 40-50% of the control bladder capacity measured during saline infusion. The effect of foot stimulation did not persist after termination of stimulation during repeated CMG tests.
  
  
  CONCLUSIONS
  This study shows the potential of noninvasive transcutaneous electrical stimulation of somatic nerves in the foot to inhibit reflex bladder activity and treat overactive bladder symptoms.
authors.affiliation: Department of Urology, University of Pittsburgh, Pittsburgh, PA, USA. cftai@pitt.edu
authors.forename: Changfeng
authors.initials: C
authors.lastname: Tai
authors.forename: Bing
authors.initials: B
authors.lastname: Shen
authors.forename: Mang
authors.initials: M
authors.lastname: Chen
authors.forename: Jicheng
authors.initials: J
authors.lastname: Wang
authors.forename: Hailong
authors.initials: H
authors.lastname: Liu
authors.forename: James R
authors.initials: JR
authors.lastname: Roppolo
authors.forename: William C
authors.initials: WC
authors.lastname: de Groat
mesh_terms: D000344:Afferent Pathways; D000818:Animals; D002415:Cats; D005260:Female; D005528:Foot / Q000294:innervation* / Q000502:physiology; D004561:Transcutaneous Electric Nerve Stimulation / Q000379:methods*; D001743:Urinary Bladder / Q000294:innervation* / Q000503:physiopathology; D053201:Urinary Bladder, Overactive / Q000628:therapy*; D014554:Urination / Q000502:physiology*; D014563:Urodynamics / Q000502:physiology
references.citation: Neurourol Urodyn. 2007;26(1):19-28; discussion 36
references.pmid: 17078071
references.citation: J Urol. 1983 Jan;129(1):197-9
references.pmid: 6402609
references.citation: Neurourol Urodyn. 1993;12(3):241-52; discussion 253
references.pmid: 8330047
references.citation: BJU Int. 2006 Mar;97(3):547-50
references.pmid: 16469023
references.citation: Behav Brain Res. 1998 May;92(2):127-40
references.pmid: 9638955
references.citation: Am J Physiol Renal Physiol. 2008 Mar;294(3):F591-602
references.pmid: 18160624
references.citation: Nat Clin Pract Urol. 2008 Mar;5(3):118-9
references.pmid: 18195723
references.citation: J Urol. 1983 Feb;129(2):405-10
references.pmid: 6834523
references.citation: Neurourol Urodyn. 2005;24(7):643-7
references.pmid: 16178000
references.citation: Exp Neurol. 2006 Jan;197(1):225-34
references.pmid: 16271266
references.citation: Expert Rev Med Devices. 2007 Sep;4(5):693-8
references.pmid: 17850204
references.citation: J Auton Nerv Syst. 1980 Mar;1(3):229-41
references.pmid: 7440895
references.citation: J Physiol. 1966 Jul;185(1):185-96
references.pmid: 5229397
references.citation: Urology. 1975 Dec;6(6):663-6
references.pmid: 1105926
references.citation: BJU Int. 2009 Feb;103(4):530-6
references.pmid: 19007383
references.citation: BJU Int. 2007 Oct;100(4):835-9
references.pmid: 17822464
references.citation: J Urol. 2009 Sep;182(3):1055-61
references.pmid: 19616802
references.citation: J Urol. 1983 Jan;129(1):78-9
references.pmid: 6600794
references.citation: J Urol. 1992 Jan;147(1):100-3
references.pmid: 1729491
references.citation: Pharmacol Rev. 2004 Dec;56(4):581-631
references.pmid: 15602011