Role of pudendal afferents in voiding efficiency in the rat

1 Department of Biomedical Engineering, Duke University, Durham, North Carolina; 2 Institute of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan; and 3 Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan Submitted 19 April 2007 ; accepted in final form 6 December 2007 The reciprocal activities of the bladder and external urethral sphincter (EUS) are coordinated by descending projections from the pontine micturition center but are subjected to modulation by peripheral afferent inputs. Transection of the somatic pudendal nerve innervating the striated EUS decreases voiding efficiency and increases residual urine in the rat. The reduction in voiding efficiency was attributed to the lack of phasic bursting activity of the EUS following denervation. However, transection of the pudendal nerve also eliminates somatic sensory feedback that may play a role in voiding. We hypothesized that feedback from pudendal afferents is required for efficient voiding and that the loss of pudendal sensory activity contributes to the observed reduction in voiding efficiency following pudendal nerve transection. Quantitative cystometry in urethane anesthetized female rats following selective transection of pudendal nerve branches, following chemical modulation of urethral afferent activity, and following neuromuscular blockade revealed that pudendal nerve afferents contributed to efficient voiding. Sensory feedback augmented bladder contraction amplitude and duration, thereby increasing the driving force for urine expulsion. Second, sensory feedback was necessary to pattern appropriately the EUS activity into alternating bursts and quiescence during the bladder contraction. These findings demonstrate that the loss of pudendal sensory activity contributes to the reduction in voiding efficiency observed following pudendal nerve transection, and illustrate the importance of urethral sensory feedback in regulating bladder function. bladder; urethra; sensory feedback; external urethral sphincter Address for reprint requests and other correspondence: W. M. Grill, Dept. of Biomedical Engineering, Duke Univ., Hudson Hall 136, Box 90281, Durham, NC (e-mail: warren.grill{at}duke.edu )