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Meredith J McGee, Warren M Grill
Electrical stimulation of the pudendal nerve (PN) is a promising approach to restore continence and micturition following bladder dysfunction resulting from neurological disease or injury. Although the pudendo-vesical reflex and its physiological properties are well established, there is limited understanding of the specific neural mechanisms that mediate this reflex. We sought to develop a computational model of the spinal neural network that governs the reflex bladder response to PN stimulation. We implemented and validated a neural network architecture based on previous neuroanatomical and electrophysiological studies...
June 2016: Journal of Computational Neuroscience
Meredith J McGee, Warren M Grill
AIMS: Reflex bladder activation and inhibition by electrical stimulation of pudendal nerve (PN) afferents is a promising approach to restore control of bladder function in persons with lower urinary tract dysfunction caused by disease or injury. The objective of this work was to determine whether bladder activation evoked by pudendal afferent stimulation was dependent on the temporal pattern of stimulation, and whether specific temporal patterns of stimulation produced larger bladder contractions than constant frequency stimulation...
July 3, 2015: Neurourology and Urodynamics
Natalia Vasquez, Vernie Balasubramaniam, Anna Kuppuswamy, Sarah Knight, Judith Susser, Angela Gall, Peter H Ellaway, Michael D Craggs
AIMS: To reveal the effectiveness of corticospinal drive in facilitating the pudendal reflex in the anal sphincter muscle, as a surrogate marker for the urethral sphincter, in incomplete spinal cord injury (iSCI). METHODS: Three neurologically normal subjects and twenty-six subjects with incomplete, supra-sacral spinal cord injuries and symptoms of a neuropathic bladder were recruited. Incontinence was assessed using the International Consultation on Incontinence Modular Questionnaire (ICIQ)...
April 2015: Neurourology and Urodynamics
Zhengwei Yuan, Wei Cheng, Ana Hou, Wei Wang, Shucheng Zhang, Dan Liu, Fei Gao, Hui Li, Weilin Wang
BACKGROUND & AIMS: Spina bifida occulta (SBO) is a common developmental variant. The aim of this study was to re-examine the possible association between SBO and constipation in children. METHODS: A total of 113 children with constipation underwent plain abdominal radiography, anorectal manometry, neurophysiologic study, electromyography testing, and colonic transit study. Eighty-six were diagnosed with functional constipation (FC) and 27 were diagnosed with nonretentive fecal incontinence (NRFI)...
December 2008: Clinical Gastroenterology and Hepatology
Marcos Vinicius Guarnieri Catarin, Gilberto Mastrocola Manzano, João A M Nóbrega, Fernando G Almeida, Miguel Srougi, Homero Bruschini
PURPOSE: We evaluated the somatic and autonomic innervation of the pelvic floor and rhabdosphincter before and after nerve sparing radical retropubic prostatectomy using neurophysiological tests and correlated findings with clinical parameters and urinary continence. MATERIALS AND METHODS: From February 2003 to October 2005, 46 patients with prostate cancer were enrolled in a controlled, prospective study. Patients were evaluated before and 6 months after nerve sparing radical retropubic prostatectomy using the UCLA-PCI urinary function domain and neurophysiological tests, including somatosensory evoked potential, and the pudendo-urethral, pudendo-anal and urethro-anal reflexes...
December 2008: Journal of Urology
Geraldo de Aguiar Cavalcanti, Gilberto Mastrocola Manzano, Homero Bruschini, Lydia Maria Giuliano, Miguel Srougi, João Antônio Maciel Nóbrega
The pudendo-anal reflex was studied in a sample of 31 normal women. Responses were obtained after bilateral independent stimulation of the clitoris, with surface recordings from both sides of the external anal sphincter. Responses were elicited with double-pulses of 0.2 ms duration with a interstimulus interval of 5 ms, frequency of stimulation was lower than 0.5 Hz. A minimal of four responses were recorded after supramaximal stimulation. In one volunteer no response was recorded after unilateral stimulation...
September 2004: Arquivos de Neuro-psiquiatria
Zheng-wei Yuan, Wei-lin Wang, Yu-zuo Bai, Wei Wang
OBJECTIVE: Although better anorectal function was achieved due to the advanced operation procedures, the fecal incontinence and constipation still remain as major postoperative complications. The aim of this study was to design a individualized biofeedback program based on the underlying dysfunctions and to assess the short-term and long-term clinical and quality of life outcomes for patients with imperforate anus. METHODS: Thirty-one patients were treated using individualized biofeedback program according to their different dysfunctions after completed assessment of anorectal function...
March 17, 2004: Zhonghua Yi Xue za Zhi [Chinese medical journal]
B Schurch, I Reilly, A Reitz, A Curt
Up until now, the exact mechanism by which neuromodulation using sacral nerve stimulation works still remains unknown. Recent studies of pelvic floor contraction during peripheral nerve evaluation (PNE) have shown that several muscle responses are reflexly mediated. However, whether these reflexes originate from a segmental level within the sacral spinal cord or from supraspinal neuronal centers involving spino-bulbospinal pathways remains to be determined. Therefore, recordings of external anal sphincter reflexes during PNE in complete spinal cord injury (SCI) patients was performed...
May 2003: World Journal of Urology
F García Montes, A R Mundy, S Knight, M D Craggs
INTRODUCTION: The aim of this study was to assess the effects of peripheral functional electrical stimulation (FES) in patients with detrusor instability (DI) secondary to obstructive Benign Prostatic Hyperplasia (BPH). SUBJECTS, MATERIAL & METHODS: Nine patients with urodynamically proven DI secondary to BPH were investigated. Sensory and pudendo-anal reflex thresholds were determined in each patient to individually optimise FES. A standard fill cystometry was then performed and individually optimised FES was given when an unstable detrusor contraction occurred...
April 2002: Actas Urologicas Españolas
Z Yuan, W Wang, S Ji
OBJECTIVE: To explore the functional damage of the nerves controlling external anal sphincter in patients with congenital anorectal malformation and to design a new method for measuring the conductive time of sacral spinal center in the pudendo-anal reflex arc. METHODS: 45 patients with anorectal malformation and 20 normal subjects were subjected to detect the latency for pudendo-anal reflex, spinal-anal response and evoked potential of caude equine simultaneously...
January 2000: Zhonghua Yi Xue za Zhi [Chinese medical journal]
A P Kirkham, N C Shah, S L Knight, P J Shah, M D Craggs
STUDY DESIGN: Laboratory investigation using serial slow-fill cystometrograms. OBJECTIVES: To examine the acute effects of different modes of dorsal penile nerve stimulation on detrusor hyperreflexia, bladder capacity and bladder compliance in spinal cord injury (SCI). SETTING: Spinal Injuries Unit, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK. METHODS: Fourteen SCI patients were examined. Microtip transducer catheters enabled continuous measurement of anal sphincter, urethral sphincter and intravesical pressures...
August 2001: Spinal Cord
Z Yuan, Y Bai, Z Zhang, S Ji, Z Li, W Wang
BACKGROUND/PURPOSE: Abnormality of innervation of external anal sphincter is one of the most important factors affecting postoperative anorectal function. The abnormalities of lumbosacral nerves have been reported in many radiological and histopathologic studies. There are few reports on the neurophysiological changes in children with anoractal malformation. The aim of this study was to examine the functional changes of nerves to the external anal sphincter in anorectal malformation. METHODS: Forty-five patients with anorectal malformation underwent studies of latencies of pudendo-anal reflex, spinoanal response, and evoked potential of cauda equine simultaneously...
July 2000: Journal of Pediatric Surgery
S A Rommel, G A Early, K A Matassa, D A Pabst, W A McLellan
BACKGROUND: Seal reproductive systems are surrounded by thermogenic muscle and insulating blubber, suggesting elevated temperatures at the gonads and uterus. In the limbs of terrestrial mammals, cooled blood returning from superficial veins is mixed proximally with warm blood returning from deep veins. Thus, mixed cool-superficial and warm-deep venous blood from the hind limbs is returned to the central circulation. METHODS: We describe structures observed in salvaged carcasses of harbor (Phoca vitulina), gray (Haliochoerus gryphus), harp (Phoca groendlandica), hooded (Cystophora cristata), and ringed (Phoca hispida) seals...
November 1995: Anatomical Record
X Yuan, Z Lin, Q He
Soft tissue defects of the hand have been repaired with free pudendo-femoral skin flaps in 13 patients. The results are quite satisfactory in all cases. The flaps are thin with little fat to interfere with post-operative appearance. The donor sites are well-hidden and can be primarily closed with no functional disturbances. Hence the ideal donor site for soft tissue defects of the hand.
March 1994: Chinese Journal of Plastic Surgery and Burns
J S Varma, A N Smith, A McInnes
A reproducible electrophysiological technique is described to determine the latency of reflex contraction of the external anal sphincter in response to stimulation of the dorsal genital nerve: the pudendo-anal reflex. This was studied in 38 asymptomatic control subjects and 20 women with neurogenic faecal incontinence, supplemented by determination of the mean motor unit potential duration (MUPD) of the external anal sphincter and anorectal manometry. The reflex latency in the control group was 38.5 +/- 5.8 (SD) ms and appeared to be independent of age or sex...
December 1986: Journal of Neurology, Neurosurgery, and Psychiatry
J S Varma, A N Smith
Anorectal manometry and electrophysiological studies of the pelvic floor were performed in eight patients who had undergone anterior resection of the rectum with mucosal proctectomy and colo-anal sleeve anastomosis for radiation rectal injury. There is a severe reduction in the compliance of the neorectum and in the maximal tolerable volume. Maximum basal anal canal pressure and physiological sphincter length are also significantly reduced although the 'squeeze' pressure of the external anal sphincter and the latency of the pudendo-anal reflex were unaffected...
April 1986: British Journal of Surgery
A Sikorski, J Olszewski, E Miekoś
The pudendal nerve was examined in 100 cadavers of both sexes. Because of the variable number of trunks of the pudendal nerve, 5 types were distinguished: one-trunked; two-trunked, rectopudendal; two-trunked, pudendo-penile (or -clitoridal); three-trunked, recto-perineo-penile (or -clitoridal); four-trunked, recto-perineo-perineopenile (or -clitoridal). The authors' suggestions make it possible to perform selective pudendectomy, consisting in denervation of the sphincter urethrae muscle by neurectomy of the perineal branches of the pudendal nerve...
1987: International Urology and Nephrology
J S Varma, A N Smith
Fifteen women with intractable chronic idiopathic constipation dating from adolescence were investigated by anorectal manometry, neurophysiological evaluation of the conus medullaris and external anal sphincter. Comparison was made with 25 asymptomatic female control subjects. Urological disturbances were common amongst the constipated, in five of whom incidental lumbosacral spinal dysraphism was found. No differences in sphincter pressures or the rectosphincteric reflex were demonstrable between the two groups...
July 1988: Gut
K E McKenna, I Nadelhaft
The pudendo-pudendal reflex (bulbocavernosus reflex) was studied in male and female rats. Electrical stimulation of pudendal nerve afferents induced reflex volleys in ipsi- and contralateral pudendal nerves. The early components of the reflex were unaffected by acute spinal transection. The reflex was shown to be polysynaptic and bilaterally organized. No qualitative differences were noted between males and females, but a significantly longer central delay was observed in female rats, compared to males.
June 1989: Journal of the Autonomic Nervous System
N R Binnie, B M Kawimbe, M Papachrysostomou, A N Smith
An electrical stimulator has been devised to treat neurogenic faecal incontinence caused by pudendal nerve neuropathy and works on the basis of repeated stimulation of the pudendo-anal reflex arc. Although conduction in the pudendo-anal reflex arc may be prolonged, and is so in neurogenic faecal incontinence, it must be shown to be present before the method can be used. This stimulation results in an immediate rise in the pressure in the anal canal and a significant increase in the electromyographic activity of the external anal sphincter...
September 1990: Gut
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