Brian M Balog1,2,3, Kangli Deng4, Vinod Labhasetwar1, Kathryn J Jones5,6, Margot S Damaser1,2,7. 1. Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic. 2. Advanced Platform Technology Center, Louis Stokes Cleveland Veterans Affairs Medical Center, Cleveland. 3. Department of Biology, University of Akron, Akron, Ohio, USA. 4. Department of Urology, Hubei Cancer Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, PR China. 5. Department of Anatomy and Cell Biology, School of Medicine, Indiana University. 6. Research and Development, Richard L. Roudebush VA, Indianapolis, Indiana. 7. Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio, USA.
Abstract
PURPOSE OF REVIEW: The present review highlights regenerative electrical stimulation (RES) as potential future treatment options for patients with nerve injuries leading to urological dysfunction, such as urinary incontinence, voiding dysfunction or erectile dysfunction. Additionally, it will highlight the mechanism of nerve injury and regeneration as well as similarities and differences between RES and current electrical stimulation treatments in urology, functional electrical stimulation (FES) and neuromodulation. RECENT FINDINGS: It has been demonstrated that RES upregulates brain-derived neurotrophic factor (BDNF) and its receptor to facilitate neuroregeneration, facilitating accurate reinnervation of muscles by motoneurons. Further, RES upregulates growth factors in glial cells. Within the past 2 years, RES of the pudendal nerve upregulated BDNF in Onuf's nucleus, the cell bodies of motoneurons that course through the pudendal nerve and accelerated functional recovery in an animal model of stress urinary incontinence. Additionally, electrical stimulation of the vaginal tissue in an animal model of stress urinary incontinence accelerated functional recovery. SUMMARY: RES has great potential but future research is needed to expand the potential beneficial effects of RES in the field of urology.
PURPOSE OF REVIEW: The present review highlights regenerative electrical stimulation (RES) as potential future treatment options for patients with nerve injuries leading to urological dysfunction, such as urinary incontinence, voiding dysfunction or erectile dysfunction. Additionally, it will highlight the mechanism of nerve injury and regeneration as well as similarities and differences between RES and current electrical stimulation treatments in urology, functional electrical stimulation (FES) and neuromodulation. RECENT FINDINGS: It has been demonstrated that RES upregulates brain-derived neurotrophic factor (BDNF) and its receptor to facilitate neuroregeneration, facilitating accurate reinnervation of muscles by motoneurons. Further, RES upregulates growth factors in glial cells. Within the past 2 years, RES of the pudendal nerve upregulated BDNF in Onuf's nucleus, the cell bodies of motoneurons that course through the pudendal nerve and accelerated functional recovery in an animal model of stress urinary incontinence. Additionally, electrical stimulation of the vaginal tissue in an animal model of stress urinary incontinence accelerated functional recovery. SUMMARY:RES has great potential but future research is needed to expand the potential beneficial effects of RES in the field of urology.