Surgical access and stimulation of pudendal nerve in pigs to restore the micturition control

Patients affected by lower urinary tract dysfunctions (LUTDs), such as overactive bladder, lose control of micturition with invalidating consequences on their physical, social and emotional well-being. Pudendal neuromodulation has been successfully used to treat LUTDs symptoms by injecting current through a tined lead electrode [1]. However, the epineural electrode migration compromised its efficacy and reliability [2]. Furthermore, to our knowledge, neuromodulation techniques can yet not restore the sensory perception of bladder fullness. Intraneural electrodes instead are inserted through the nerve enhancing electrode stability and providing a highly selective stimulation of nerves [3]. Intraneural stimulation has been proven to restore touch sensations in upper-limb amputees. Therefore, the selective stimulation of pudendal afferents could restore bladder fullness perception while the stimulation of efferents could restore the micturition process control. To investigate a novel approach to pudendal neuromodulation based on the use of intraneural electrodes, here we present a first explorative study on pig pudendal nerve surgical access and stimulation.