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Pudendal, but not tibial, nerve stimulation modulates vulvar blood perfusion in anesthetized rodents

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Abstract

Introduction and hypothesis

Preclinical studies have shown that neuromodulation can increase vaginal blood perfusion, but the effect on vulvar blood perfusion is unknown. We hypothesized that pudendal and tibial nerve stimulation could evoke an increase in vulvar blood perfusion.

Methods

We used female Sprague–Dawley rats for non-survival procedures under urethane anesthesia. We measured perineal blood perfusion in response to 20-minute periods of pudendal and tibial nerve stimulation using laser speckle contrast imaging (LSCI). After a thoracic-level spinalization and a rest period, we repeated each stimulation trial. We calculated average blood perfusion before, during, and after stimulation for three perineal regions (vulva, anus, and inner thigh), for each nerve target and spinal cord condition.

Results

We observed a significant increase in vulvar, anal, and inner thigh blood perfusion during pudendal nerve stimulation in spinally intact and spinalized rats. Tibial nerve stimulation had no effect on perineal blood perfusion for both spinally intact and spinalized rats.

Conclusions

This is the first study to examine vulvar hemodynamics with LSCI in response to nerve stimulation. This study demonstrates that pudendal nerve stimulation modulates vulvar blood perfusion, indicating the potential of pudendal neuromodulation to improve genital blood flow as a treatment for women with sexual dysfunction. This study provides further support for neuromodulation as a treatment for women with sexual arousal disorders. Studies in unanesthetized animal models of genital arousal disorders are needed to obtain further insights into the mechanisms of neural control over genital hemodynamics.

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Acknowledgements

We thank Tim Brown of Moor Instruments for assistance with data collection and analysis, Eric Kennedy and Ahmad Jiman for their help in experiment preparation, and the University of Michigan Unit for Laboratory Animal Medicine for animal husbandry. This study was supported in part by National Institutes of Health Award T32NS115724.

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Authors and Affiliations

  1. Biomedical Engineering Department, University of Michigan, 2800 Plymouth Road, Ann Arbor, MI, 41809-2800, USA

    Elizabeth C. Bottorff & Tim M. Bruns

  2. Biointerfaces Institute, University of Michigan, Ann Arbor, MI, USA

    Elizabeth C. Bottorff & Tim M. Bruns

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  1. Elizabeth C. Bottorff
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  2. Tim M. Bruns
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Contributions

EC Bottorff: project development, data collection, data analysis, manuscript writing

TM Bruns: project development, manuscript writing

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Correspondence to Tim M. Bruns.

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Bottorff, E.C., Bruns, T.M. Pudendal, but not tibial, nerve stimulation modulates vulvar blood perfusion in anesthetized rodents. Int Urogynecol J 34, 1477–1486 (2023). https://doi.org/10.1007/s00192-022-05389-x

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