Analysis of functional restoration of the lower urinary tract after spinal cord injury using functional electrical stimulation on pudendal nerve

Objective: On the basis of frequency-dependence of the reflex arc between pudendal nerve and bladder, this paper aims to present a new reconstruction method using functional electrical stimulation (FES) on pudendal nerve. Methods: Considering the pudendal nerve as stimulus object, this paper adopts three kinds of electrical stimulation to restore function of the lower urinary tract, which respectively are low frequency (1Hz-9Hz) stimulation, intermediate frequency (15Hz-35Hz) stimulation and high frequency (1K Hz-10K Hz) stimulation. Results: Low frequency (1Hz-9Hz) electrical stimulation can achieve the best clinical result at 5Hz, so as to restore the storing function of the lower urinary tract after SCI. In intermediate frequency (15Hz-35Hz) electrical stimulation, electrical stimulation of 19Hz-21Hz can induce the maximize value of bladder pressure to treat detrusor underactivity. High frequency (1K Hz-10K Hz) electrical stimulation can block the conduction of pudendal nerve reversibly. The electrical stimulation of 10K Hz, 10mA, combined with intermediate frequency electrical stimulation of 20Hz achieves the best improvement of voiding efficiency to 20%, which can be the treatment of detrusor-sphincter dyssynergia after spinal cord injury, so as to restore the voiding function of the lower urinary tract after SCI. Above all, the method mentioned in this paper is available for reconstruction of the lower urinary tract after spinal cord injury.

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