Temporal patterns of pudendal afferent stimulation modulate reflex bladder activation

Electrical stimulation of pudendal nerve (PN) afferents to cause reflex activation or inhibition of the bladder is a promising approach to restore control of bladder function in persons with dysfunction caused by disease or injury. The objective of this work was to evaluate the effects of novel temporal patterns of stimulation on the size of isovolumetric stimulation-evoked reflex bladder contractions and determine if the temporal pattern, of stimulation, like frequency, modulates the reflex bladder response to stimulation. The temporal pattern of stimulation significantly affected the size of bladder contractions evoked by stimulation in anesthetized cats. Patterns with pauses and random patterns evoked significantly smaller bladder contractions, while patterns with subtle changes in inter-pulse-intervals (IPIs), ramp trains and alternating IPI trains, occasionally evoked larger bladder contractions than constant frequency stimulation. The use of new temporal patterns of electrical stimulation should be considered in the development of neural prosthetics for the restoration of lower urinary tract function.