Detrusor and blood pressure responses to dorsal penile nerve stimulation during hyperreflexic contraction of the bladder in patients with cervical cord injury.

OBJECTIVE

To investigate the immediate effect of dorsal penile nerve (DPN) stimulation on detrusor pressure (P(det)) and blood pressure during hyperreflexic contractions of the bladder in patients with cervical spinal cord injury (SCI).

DESIGN

Blood pressure and P(det) monitoring during cystometry with and without DPN stimulation.

SETTING

Urodynamic laboratory in a university hospital in Korea.

PARTICIPANTS

Eight men (age range, 20-55y) with cervical SCI that was incurred from 4 months to 10 years before this study.

INTERVENTION: During water cystometry, blood pressure was monitored with an intra-arterial catheter introduced percutaneously into the radial artery and was recorded simultaneously with the P(det). Blood pressure was also measured manually with an electronic blood pressure cuff. Electric stimulation was applied to the DPN by using surface electrodes each time a bladder contraction was detected. Stimulation intensity was twice the threshold of the pudendal-anal reflex.

MAIN OUTCOME MEASURES: P(det), systolic blood pressure, and diastolic blood pressure.

RESULTS

As P(det) increased, the blood pressure increased in all cases. All the reflex contractions of the bladder were effectively suppressed by DPN stimulation, and as the P(det) decreased during stimulation, radial arterial pressure also decreased immediately and significantly.

CONCLUSIONS

DPN stimulation can decrease P(det) and the increased blood pressure associated with it.