Detrusor and Blood Pressure Responses to Dorsal Penile Nerve Stimulation during Hyper-reflexic Bladder Contraction in Patients with Cervical Cord Injury.

, Lee, Young Hee; , Creasey, Graham H; , Lee, Sang Shin; , Kim, Taek Sun; , Song, Jae Man; , Song, Ki Hak; , Lim, Hyunkyo

Original Article

Journal of the Korean Academy of Rehabilitation Medicine 2002;26(4):409-413.

Lee, Young Hee , Creasey, Graham H , Lee, Sang Shin , Kim, Taek Sun , Song, Jae Man , Song, Ki Hak , Lim, Hyunkyo

¹Department of Rehabilitation Medicine, Yonsei University Wonju College of Medicine, Korea.
²Department of Urology, Yonsei University Wonju College of Medicine, Korea.
³Department of Anesthesiology, Yonsei University Wonju College of Medicine, Korea.
⁴Case Western Reserve University, U.S

경수손상인에서 배부 음경신경에 대한 전기자극이 혈압에 미치는 영향

이영희, Graham H Creasey¹,이상신, 김택선, 송재만^2,송기학^2,임현교³

연세대학교 원주의과대학 재활의학교실, ²비뇨기과학교실, ³마취과학교실, ¹Case Western Reserve University

Abstract

Objective
To investigate the immediate effect of dorsal penile nerve (DPN) stimulation on detrusor pressure (P_det) and blood pressure (BP) during hyper-reflexic contractions of the bladder in patients with cervical spinal cord injury (SCI).

Method
The subjects were eight male patients with cervical SCI who had symptoms of autonomic dysreflexia. During water-cystometry, BP was monitored using an intra-arterial catheter into the radial artery, and was recorded simultaneously with the P_det. Electrical stimulation was applied to the DPN, using surface electrodes each time a bladder contraction was detected. Baseline BP and BP at the first and the last hyper-reflexic contractions of bladder were measured with P_det, respectively.

Results
As P_detincreased, the BP increased in all cases. The reflex contractions of the bladder were effectively suppressed by DPN stimulation, and as the P_detdecreased during stimulation, radial arterial pressure also decreased immediately and significantly.

Conclusion
DPN stimulation can lower both P_detand the elevated BP. (J Korean Acad Rehab Med 2002; 26: 409- 413)

Key Words: Autonomic dysreflexia, Electrical stimulation, Spinal cord injury, Blood pressure, Neurogenic bladder, Dorsal penile nerve stimulation