Combination of foot stimulation and tolterodine treatment eliminates bladder overactivity in cats. Issue 8 (29th August 2013)

• Record Type: Journal Article
• Authors: Schwen, Zeyad; Matsuta, Yosuke; Shen, Bing; Wang, Jicheng; Roppolo, James R.; de Groat, William C.; Tai, Changfeng
• Is Part Of: Neurourology and urodynamics. Volume 33:Issue 8(2014:Nov.)
• Page Start: 1266
• Page End: 1271
• Publication Date: 2013-08-29
• Subjects: Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.22479
• Languages: English
• ISSNs: 0733-2467

Abstract

<abstract abstract-type="main" xml:lang="en"> <title>Abstract</title> <sec id="nau22479-sec-0001" sec-type="section"> <title>Aims</title> <p>To determine whether transcutaneous foot stimulation combined with a lower dose tolterodine would inhibit bladder overactivity more effectively than either treatment alone.</p> </sec> <sec id="nau22479-sec-0002" sec-type="section"> <title>Methods</title> <p>Cystometrograms were performed on α‐chloralose anesthetized cats (N = 6) by infusing 0.25% acetic acid (AA) to induce bladder overactivity. Foot stimulation (5 Hz) was applied at 2 and 4 times the threshold (T) intensity in volts (i.e., 2T or 4T) for inducing toe movement to inhibit bladder overactivity. Cumulative doses of tolterodine (0.003–0.3 mg/kg, i.v.) were also administered to determine the effect of combination treatment.</p> </sec> <sec id="nau22479-sec-0003" sec-type="section"> <title>Results</title> <p>AA irritation of the bladder significantly (<italic>P</italic> < 0.0001) reduced bladder capacity to 23.6 ± 7.1% of saline control capacity. Foot stimulation alone at 2T and 4T inhibited bladder overactivity and significantly (<italic>P</italic> < 0.0001) increased bladder capacity to 50.7 ± 6.8% and 79.0 ± 11.6% of saline control, respectively. Tolterodine alone at 0.3 mg/kg significantly (<italic>P</italic> < 0.05) increased bladder capacity to 65.6 ± 15.5% of saline control. However, when tolterodine at a threshold dose (0.3 mg/kg) was combined with foot stimulation, the bladder capacity was significantly (<italic>P</italic> < 0.05) increased to 86.2 ± 6.2% and 107.9 ± 10.6% by 2T and 4T stimulation, respectively. Complete inhibition of bladder overactivity could be achieved at a lower tolterodine dose (0.1 mg/kg) when combined with 4T stimulation (97.0 ± 11.2% of saline control). The amplitude of micturition contraction was not changed by tolterodine treatment.</p> </sec> <sec id="nau22479-sec-0004" sec-type="section"> <title>Conclusions</title> <p>This study suggests a novel, efficacious, non‐invasive therapy by combining foot stimulation with a lower dose tolterodine to treat bladder overactivity. It also provides the first objective evidence supporting an additive therapeutic benefit of neuromodulation and antimuscarinic combination treatment. <italic>Neurourol. Urodynam. 33:1266–1271, 2014</italic>. © 2013 Wiley Periodicals, Inc.</p> </sec> </abstract>