A Shafik1. 1. Department of Surgery and Experimental Research, Faculty of Medicine, Cairo University, Egypt.
Abstract
OBJECTIVES: To study the effect of sacral magnetic stimulation (MS) on the neuropathic rectum and urinary bladder in dogs. It has been demonstrated in a canine model and in humans that sacral MS of both the empty and full rectum effected a significant increase in rectal and vesical pressures. Evacuation of the full rectum, as well as balloon expulsion, were achieved. METHODS: In 15 dogs, bilateral pelvic ganglionectomy was carried out, and rectal and vesical denervation was confirmed by bethanechol and atropine testing. Sacral MS of the empty and full rectum and urinary bladder were performed by means of a magnetic stimulator and coil. The electromyographic (EMG) response of the rectus abdominus muscles to sacral MS was recorded. RESULTS: After pelvic ganglionectomy, the rectal, vesical, anal, and urethral pressures revealed a significant decrease (all P <0.05). On sacral MS of the empty rectum and urinary bladder, rectal and vesical pressures increased (both P <0.001) and anal and urethral pressures did not change (both P >0.05). Atropine injection abolished the rectal and vesical response to sacral MS; bethanechol did not. During sacral MS, no EMG activity of the rectus abdominus muscles was recorded. Intermittent sacral MS of the full rectum and urinary bladder raised rectal and vesical pressures (both P <0.001) and effected evacuation. CONCLUSIONS: Sacral MS causes evacuation of the neuropathic rectum and urinary bladder in a canine model. The technique is simple, noninvasive, nonradiologic, and cost-effective and has no adverse effects. It is suggested that it be used for evacuation of the neuropathic rectum and urinary bladder in patients with spinal cord injury.
OBJECTIVES: To study the effect of sacral magnetic stimulation (MS) on the neuropathic rectum and urinary bladder in dogs. It has been demonstrated in a canine model and in humans that sacral MS of both the empty and full rectum effected a significant increase in rectal and vesical pressures. Evacuation of the full rectum, as well as balloon expulsion, were achieved. METHODS: In 15 dogs, bilateral pelvic ganglionectomy was carried out, and rectal and vesical denervation was confirmed by bethanechol and atropine testing. Sacral MS of the empty and full rectum and urinary bladder were performed by means of a magnetic stimulator and coil. The electromyographic (EMG) response of the rectus abdominus muscles to sacral MS was recorded. RESULTS: After pelvic ganglionectomy, the rectal, vesical, anal, and urethral pressures revealed a significant decrease (all P <0.05). On sacral MS of the empty rectum and urinary bladder, rectal and vesical pressures increased (both P <0.001) and anal and urethral pressures did not change (both P >0.05). Atropine injection abolished the rectal and vesical response to sacral MS; bethanechol did not. During sacral MS, no EMG activity of the rectus abdominus muscles was recorded. Intermittent sacral MS of the full rectum and urinary bladder raised rectal and vesical pressures (both P <0.001) and effected evacuation. CONCLUSIONS: Sacral MS causes evacuation of the neuropathic rectum and urinary bladder in a canine model. The technique is simple, noninvasive, nonradiologic, and cost-effective and has no adverse effects. It is suggested that it be used for evacuation of the neuropathic rectum and urinary bladder in patients with spinal cord injury.