title: Electrical stimulation of anal sphincter or pudendal nerve improves anal sphincter pressure.
abstract: OBJECTIVE
  Stimulation of the pudendal nerve or the anal sphincter could provide therapeutic options for fecal incontinence with little involvement of other organs. The goal of this project was to assess the effects of pudendal nerve and anal sphincter stimulation on bladder and anal pressures.
  
  
  METHODS
  Ten virgin female Sprague Dawley rats were randomly allocated to control (n = 2), perianal stimulation (n = 4), and pudendal nerve stimulation (n = 4) groups. A monopolar electrode was hooked to the pudendal nerve or placed on the anal sphincter. Aballoon catheter was inserted into the anus to measure anal pressure, and a catheter was inserted into the bladder via the urethra to measure bladder pressure. Bladder and anal pressures were measured with different electrical stimulation parameters and different timing of electrical stimulation relative to spontaneous anal sphincter contractions.
  
  
  RESULTS
  Increasing stimulation current had the most dramatic effect on both anal and bladder pressures. An immediate increase in anal pressure was observed when stimulating either the anal sphincter or the pudendal nerve at stimulation values of 1 mA or 2 mA. No increase in anal pressure was observed for lower current values. Bladder pressure increased at high current during anal sphincter stimulation, but not as much as during pudendal nerve stimulation. Increased bladder pressure during anal sphincter stimulation was due to contraction of the abdominal muscles.
  
  
  CONCLUSIONS
  Electrical stimulation caused an increase in anal pressures with bladder involvement only at high current. These initial results suggest that electrical stimulation can increase anal sphincter pressure, enhancing continence control.
authors.affiliation: Department of Biomedical Engineering, Cleveland Clinic, Cleveland, Ohio, USA.
authors.forename: Margot S
authors.initials: MS
authors.lastname: Damaser
authors.forename: Levilester
authors.initials: L
authors.lastname: Salcedo
authors.forename: Guangjian
authors.initials: G
authors.lastname: Wang
authors.forename: Paul
authors.initials: P
authors.lastname: Zaszczurynski
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Cruz
authors.forename: Robert S
authors.initials: RS
authors.lastname: Butler
authors.forename: Hai-Hong
authors.initials: HH
authors.lastname: Jiang
authors.forename: Massarat
authors.initials: M
authors.lastname: Zutshi
mesh_terms: D001003:Anal Canal / Q000294:innervation*; D000818:Animals; D004558:Electric Stimulation / Q000379:methods*; D005242:Fecal Incontinence / Q000503:physiopathology / Q000517:prevention & control; D005260:Female; D011312:Pressure; D060525:Pudendal Nerve; D011897:Random Allocation; D051381:Rats; D017207:Rats, Sprague-Dawley; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000294:innervation*