Effects of functional electrical stimulation on the urethral closing muscles.
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Adolescent↗
Biomedical subjects
S Plevnik
Publications and source records attributed to S Plevnik.
The mechanisms of the action of electrical stimulation of muscles.
The mechanisms of the action of electrical stimulation of muscles are discussed. We believe that the principal cause for the good results obtained in cases of stress incontinence with electrical stimulation must be due to the formation of a better reflex in contraction of the muscles of the pelvic floor. This, however, envolves changes at the level of the spinal cord. By the help of stimulation the patient learns to use the urethral sphincter and secondary forces of retention in a better and a more proper way. The good results obtained in the treatment of some cases of nocturnal enuresis by anal plugs require yet another explanation. It can be considered that in nocturnal enuresis the unconscious inhibition of the reflex mechanism for emptying the bladder is not developed enough. From the experience we know that vigorous voluntary activation of the muscles of the pelvic floor inhibits the contraction of the detrusor muscle. In this way it is possible to depress the urging sensation to urinate. In the paper we have tried to demonstrate this mechanism objectively. On the basis of our findings we believe that the good results in treating nocturnal enuresis may be due to this mechanism of stimulation.
Electric Stimulation↗
Model of the proximal urethra: measurement of the urethral stress profile.
Research on the activity of the urinary tract has led to the creation of a theoretical mechanical model where elastic forces, affecting rigid segments represent the living tissue of the urethral walls whereby it is assumed that the tissue acts as an elastic material. Such a model provides a clearer picture of changes in the physical parameters of the elastic walls of the urethra and facilitates better analysis of measurement errors. Artefacts make it exceptionally difficult to accurately measure the urethral pressure profile. The known methods have a measurement error of at least 30%. We have been trying to eliminate the basic error caused by the size of the measuring sensor. The methods involves measuring the urethral pressure profile in one patients using several sensors of varying diameters. The problem was defined mathematically. By extrapolation of measuring points, the value of elastic force under normal conditions can be obtained. Preliminary results of pressure profile measurements in our patients are much more accurate than those of other currently known measuring techniques. It is too early, however, to predict the extent of increased objectivity in the results of the new method for measuring urethral pressure profile, with and without functional electrical stimulation. The parameters of stimuli produced by our electrical stimulators will be based upon these findings.
Electric Stimulation↗