Electrical stimulation of the dorsal clitoral nerve in the treatment of idiopathic defecatory urgency. A pilot study.

Purpose: To investigate the effect of dorsal clitoral nerve stimulation (DCNS) on bothersome urgency to defecate with or without fecal incontinence and the patient-reported discomfort or adverse effect with the method.

Methods: For dorsal clitoral nerve stimulation, a battery powered, handheld stimulator was used, set to a pulse width of 200 µs and a frequency of 20 Hz. One electrode was placed at the preputium of the clitoris and acted as cathode while an anode electrode was placed on the belly.

Diamond/Porous Titanium Nitride Electrodes With Superior Electrochemical Performance for Neural Interfacing.

Robust devices for chronic neural stimulation demand electrode materials which exhibit high charge injection ( ) capacity and long-term stability. Boron-doped diamond (BDD) electrodes have shown promise for neural stimulation applications, but their practical applications remain limited due to the poor charge transfer capability of diamond. In this work, we present an attractive approach to produce BDD electrodes with exceptionally high surface area using porous titanium nitride (TiN) as interlayer template.

Minimizing a Wireless Passive LC-Tank Sensor to Monitor Bladder Pressure: A Simulation Study.

In this simulation study, a wireless passive LC-tank sensor system was characterized. Given the application of continuous bladder monitoring, a specific system was proposed in terms of coil geometries and electronic circuitry. Coupling coefficients were spatially mapped by simulation, as a function of both coil distance, and longitudinal and transverse translation of the sensor relative to the antenna.

Biofouling resistance of boron-doped diamond neural stimulation electrodes is superior to titanium nitride electrodes in vivo.

Objective: The goal of this study was to assess the electrochemical properties of boron-doped diamond (BDD) electrodes in relation to conventional titanium nitride (TiN) electrodes through in vitro and in vivo measurements.

Approach: Electrochemical impedance spectroscopy, cyclic voltammetry and voltage transient (VT) measurements were performed in vitro after immersion in a 5% albumin solution and in vivo after subcutaneous implantation in rats for 6 weeks.

Main Results: In contrast to the TiN electrodes, the capacitance of the BDD electrodes was not significantly reduced in albumin solution.

Subject-Controlled, On-demand, Dorsal Genital Nerve Stimulation to Treat Urgency Urinary Incontinence; a Pilot.

Objectives: To evaluate the effect of subject-controlled, on-demand, dorsal genital nerve (DGN) stimulation on non-neurogenic urgency urinary incontinence (UUI) in a domestic setting.

Materials And Methods: Non-neurogenic patients >18 years with overactive bladder symptoms and UUI were included. Exclusion criteria were mainly stress urinary incontinence.

Influence of implantation on the electrochemical properties of smooth and porous TiN coatings for stimulation electrodes.

Objective: To determine whether changes in electrochemical properties of porous titanium nitride (TiN) electrodes as a function of time after implantation are different from those of smooth TiN electrodes.

Approach: Eight smooth and 8 porous TiN coated electrodes were implanted in 8 rats. Before implantation, voltage transients, cyclic voltammograms and impedance spectra were recorded in phosphate buffered saline (PBS).

Electrochemical properties of titanium nitride nerve stimulation electrodes: an in vitro and in vivo study.

The in vivo electrochemical behavior of titanium nitride (TiN) nerve stimulation electrodes was compared to their in vitro behavior for a period of 90 days. Ten electrodes were implanted in two Göttingen minipigs. Four of these were used for electrical stimulation and electrochemical measurements.

Subject-controlled stimulation of dorsal genital nerve to treat neurogenic detrusor overactivity at home.

Aims: To investigate the effects of subject controlled dorsal genital nerve (DGN) electrical stimulation on neurogenic detrusor overactivity (NDO) in subjects at home.

Methods: Subjects underwent a 5-day study at home with DGN stimulation. Stimulation was provided with surface electrodes placed either on the dorsal penile shaft in males and on or close to the clitoris in females.

Dorsal genital nerve stimulation in patients with detrusor overactivity: a systematic review.

This study evaluates the outcome of trials to stimulate the dorsal genital nerve (DGN) in patients with lower urinary tract dysfunction. The aim of most studies was to suppress detrusor overactivity in patients with overactive bladder (OAB) syndrome by DGN stimulation. A literature search was performed using Pub Med, Web of Science, and Scopus databases (1980 to April 2012) for clinical trials of DGN stimulation in patients with detrusor overactivity.

Turning off sacral nerve stimulation does not affect gastric and small intestinal motility in patients treated for faecal incontinence.

Aim: Sacral nerve stimulation (SNS) reduces symptoms in up to 80% of patients with faecal incontinence (FI). Its effects are not limited to the distal colon and the pelvic floor. Accordingly, spinal or supraspinal neuromodulation have been suggested as part of the mode of action.

Fibre-selective recording from peripheral nerves using a multiple-contact cuff: report on pilot pig experiments.

A single cuff electrode with multiple-contacts permits fibre selective recording from peripheral nerves. This has been demonstrated in frog nerve in vitro and earth worm before. In this paper we apply this method successfully to the peripheral median nerve of pig in vivo.

Acute effect of electrical stimulation of the dorsal genital nerve on rectal capacity in patients with spinal cord injury.

Background: Constipation and fecal incontinence are considerable problems for most individuals with spinal cord injury (SCI). Neurogenic bowel symptoms are caused by several factors including abnormal rectal wall properties. Stimulation of the dorsal genital nerve (DGN) can inhibit bladder contractions and because of common innervation inhibitory effects are anticipated in the rectum too.

Gastric transit and small intestinal transit time and motility assessed by a magnet tracking system.

Background: Tracking an ingested magnet by the Magnet Tracking System MTS-1 (Motilis, Lausanne, Switzerland) is an easy and minimally-invasive method to assess gastrointestinal transit. The aim was to test the validity of MTS-1 for assessment of gastric transit time and small intestinal transit time, and to illustrate transit patterns detected by the system.

Methods: A small magnet was ingested and tracked by an external matrix of 16 magnetic field sensors (4 × 4) giving a position defined by 5 coordinates (position: x, y, z, and angle: θ, φ).

Detecting the onset of urinary bladder contractions using an implantable pressure sensor.

This study investigates whether signals obtained from an implantable pressure sensor placed in the urinary bladder wall could be used to detect the onset of bladder contractions. The sensor assembly was custom made using a small piezoresistive sensor die. The die was mounted on ceramic substrate (8 mm × 8 mm) and encapsulated in silicone by a two-part moulding process.

Surgical access for electrical stimulation of the pudendal and dorsal genital nerves in the overactive bladder: a review.

Purpose: The anatomy of the pudendal nerve and its nerve branches, especially the dorsal nerve of the penis and clitoris (dorsal genital nerves), and the clinical application of electrical stimulation of these nerves in patients with overactive bladder syndrome and detrusor overactivity are reviewed.

Materials And Methods: A literature search was performed using the PubMed® database and reference lists of relevant studies to obtain articles concerning the anatomy as well as the electrical stimulation of the pudendal nerve and its nerve branches in patients with overactive bladder syndrome.

Results: According to the anatomy, electrical stimulation of the pudendal nerve and the dorsal genital nerves to suppress involuntary detrusor contractions is possible at several sites along their course from the sacral nerves to the penis or clitoris.

The acute effect of dorsal genital nerve stimulation on rectal wall properties in patients with idiopathic faecal incontinence.

Aim: Faecal continence depends on several factors, including rectal wall properties. Stimulation of the dorsal genital nerve (DGN) can suppress bladder contraction and similar effects are anticipated for the rectum. In this study, the acute effect of DGN stimulation on the rectal cross-sectional area is investigated.

Electrical stimulation of the dorsal clitoral nerve reduces incontinence episodes in idiopathic faecal incontinent patients: a pilot study.

Aim: Faecal incontinence (FI) has a significant impact on quality of life. This study investigates whether stimulation of the dorsal genital nerve (DGN) improves FI symptoms.

Method: Ten female patients suffering from idiopathic FI (median age 60 years) were included in the study.

Urethral sphincter EMG-controlled dorsal penile/clitoral nerve stimulation to treat neurogenic detrusor overactivity.

The goal of this study was to investigate whether real-time external urethral sphincter (EUS) EMG-controlled dorsal genital nerve (DGN) stimulation can suppress undesired detrusor bladder contractions in patients with both neurogenic detrusor overactivity (NDO) and detrusor sphincter dyssynergia (DSD). Detrusor pressure (Pdet) and EUS EMG were recorded in 12 neurogenic patients who underwent two filling cystometries. The first one was without stimulation and was intended to confirm the NDO and DSD and to set the EMG detection threshold.

Minimal invasive electrode implantation for conditional stimulation of the dorsal genital nerve in neurogenic detrusor overactivity.

Study Design: Experimental.

Objectives: Electrical stimulation of the dorsal genital nerves (DGN) suppresses involuntary detrusor contractions (IDCs) in patients with neurogenic detrusor overactivity (DO). The feasibility of minimal invasive electrode implantation near the DGN and the effectiveness of conditional stimulation to suppress IDCs at different amplitudes in spinal cord injury (SCI) patients with DO were studied.

Rectal evacuation and antegrade colonic luminal transport by sacral anterior root stimulation in pigs.

Purpose: Electrical sacral anterior root stimulation with a selective anodal block may relieve difficulties with bowel evacuation by selective colorectal activation and anal sphincter suppression. This study compares rectal evacuation induced by anodal block with that induced by unselective stimulation.

Methods: The sacral anterior roots were stimulated with cuff electrodes in seven chloralose-anesthetized minipigs.

Limited value of bladder sensation as a trigger for conditional neurostimulation in spinal cord injury patients.

Aims: Conditional stimulation of dorsal genital nerves suppresses undesired detrusor contractions (UDC) and consequently increases bladder capacity and prevents incontinence. No clinically applicable sensor exists for reliable bladder activity monitoring as a trigger for conditional stimulation. Primary objective of this study was to determine whether bladder sensation concomitant with UDC may be used for spinal cord injury (SCI) patients to trigger neurostimulation in daily life.

Patient controlled versus automatic stimulation of pudendal nerve afferents to treat neurogenic detrusor overactivity.

Purpose: We investigated whether patients with neurogenic detrusor overactivity can sense the onset of bladder contraction and in turn suppress the contraction by electrical stimulation of the dorsal penile-clitoral nerve.

Materials And Methods: A total of 67 patients with different neurological disorders were recruited to undergo 3 filling cystometries. The first cystometry was done without stimulation.

Pelvic nerve stimulation evokes nitric oxide mediated distal rectal relaxation in pigs.

Purpose: Pelvic nerve stimulation evokes a complex motility response in the pig rectum with a proximal decrease and a distal increase in cross-sectional area. This study investigated whether the distal increase in the cross-sectional area is because of smooth muscle relaxation mediated by nitric oxide.

Methods: The pelvic nerves were stimulated with cuff electrodes in ten chloralose-anesthetized minipigs.