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Lead placement and associated nerve distribution of an implantable periurethral electrostimulator

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Abstract

The aim of this study was to determine gross and neuroanatomic features of a novel periurethral neuromuscular electrostimulator. Periurethral leads were placed in eight female cadavers. In two cases, leads were imaged after placement to enhance anatomic understanding. Pelvic viscera were removed en bloc for analysis of lead placement in the six remaining cadavers. Excised tissue was sectioned and immunostained to identify general, afferent, sympathetic, and nitric oxide synthase efferent nerve fibers. The electrodes were found within/lateral (n = 4), within/posterolateral (n = 9), and anterolateral (n = 1) to the external urethral sphincter (distance 0.25 ± 0.5, 2.9 ± 3.3, and 1.0 ± 0.0 mm, respectively). The electrode to the urethra and vagina distance averaged 7.6 ± 3.4 and 8.8 ± 4.3 mm, respectively. Variable density staining for all nerve types was found around the electrode. A periurethral electrode interfaces the external urethral sphincter, and the adjacent distribution of nerve fibers supports proposed neuromuscular therapeutic mechanisms.

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References

  1. Kelleher CJ et al (1997) A medium-term analysis of the subjective efficacy of treatment for women with detrusor instability and low bladder compliance. Br J Obstet Gynaecol 104(9):988–993

    PubMed  CAS  Google Scholar 

  2. Nissenkorn I, De Jong PR (2005) A novel surgical technique for implanting a new electrostimulation system for treating female overactive bladder: a preliminary report. BJU Int 95(9):1253–1258

    Article  PubMed  Google Scholar 

  3. Nissenkorn I et al (2004) Patient-adjusted intermittent electrostimulation for treating stress and urge urinary incontinence. BJU Int 94(1):105–109

    Article  PubMed  Google Scholar 

  4. Shafik A (1999) A study of the continence mechanism of the external urethral sphincter with identification of the voluntary urinary inhibition reflex. J Urol 162(6):1967–1971

    Article  PubMed  CAS  Google Scholar 

  5. Parsons M et al (2006) Analysis of long-term pelvic floor electrostimulation therapy for interstitial cystitis. Eur Urol Suppl 5(2):193

    Article  Google Scholar 

  6. Kenton K et al (2007) Aging and overactive bladder may be associated with loss of urethral sensation in women. Neurourol Urodyn 26(7):981–984

    Article  PubMed  Google Scholar 

  7. Geirsson G, Fall M (1999) Reflex interaction between the proximal urethra and the bladder. A clinical experimental study. Scand J Urol Nephrol 33(1):24–26

    PubMed  CAS  Google Scholar 

  8. Garry R, Roberts T, Todd J (1959) Reflexes involving the external urethral sphincter in the cat. J Physiol 149:653–665

    PubMed  CAS  Google Scholar 

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Conflicts of interest

James L. Whiteside, Kathy M. Ensrud-Bowlin, and Kenneth P. Roberts are paid consultants with American Medical Systems.

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Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, NH, 03756, USA

    James L. Whiteside

  2. Department of Medicine, University of Minnesota, MMC 508 Mayo, 312 Church St. SE, Minneapolis, MN, 55455, USA

    Kathy M. Ensrud-Bowlin

  3. American Medical Systems Inc., 10700 Bren Road West, Minnetonka, MN, 55343, USA

    Guangjian Wang & Brian P. Watschke

  4. WWAMI Medical Education Program, School of Molecular Biosciences, Washington State University-Spokane, 412 E. Spokane Falls Blvd., Spokane, WA, 99210, USA

    Kenneth P. Roberts

Authors
  1. James L. Whiteside
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  2. Kathy M. Ensrud-Bowlin
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  3. Guangjian Wang
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  4. Brian P. Watschke
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  5. Kenneth P. Roberts
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Correspondence to James L. Whiteside.

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Whiteside, J.L., Ensrud-Bowlin, K.M., Wang, G. et al. Lead placement and associated nerve distribution of an implantable periurethral electrostimulator. Int Urogynecol J 20, 325–329 (2009). https://doi.org/10.1007/s00192-008-0776-7

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  • DOI: https://doi.org/10.1007/s00192-008-0776-7

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