Studies on the feasibility of urinary bladder evacuation by direct spinal cord stimulation. I. Parameters of most effective stimulation

Abstract

In 30 female dogs, spinal cord stimulation was tested to find the optimal parameters producing good voiding and total bladder emptying. Twelve different electrodes or application modifications were examined. Variable frequencies, stimulus duration, and voltages were applied. Search of the site of highest detrusor response (micturition center) was easily identifiable. It became obvious that electrode design was not of critical importance: the responses were basically the same whether we used the wrap around electrode, which stimulates an entire level, or the coaxial electrode, which theoretically limits the current spread around its minute exposed tip. The stimulation parameters that gave the best results were: 2 to 5 volts; frequency: 10 to 15 cps; duration: 1 msec. The site of highest detrusor response was round vertebral level L5.5, corresponding to cord level S2-4, Generally, no voiding was obtained because of too high sphincteric contraction during stimulation; it appeared that a sphincteric center overlaps the micturition center in either direction. To achieve successful voiding during stimulation, a separation of these two centers with selective stimulation of the detrusor center is necessary, eliminating sphincteric contraction.