Results of the Treatment of Neurogenic Bladder Dysfunction in Spinal Cord Injury by Sacral Posterior Root Rhizotomy and Anterior Sacral Root Stimulation

Abstract

Purpose: We evaluated the results of treatment of neurogenic bladder dysfunction in spinal cord injury by sacral posterior root rhizotomy and anterior sacral root stimulation using the Finetech-Brindley stimulator.* Materials and Methods: In 52 patients with spinal cord lesions and urological problems due to hyperreflexia of the bladder complete posterior sacral root rhizotomy was performed and a Finetech-Brindley sacral anterior root stimulator was implanted. All patients were evaluated and followed with a strict protocol. A minimal 6-month foliowup is available in 47 cases.Results: Complete continence was achieved in 43 of the 47 patients with 6 months of followup. A significant increase in bladder capacity was attained in all patients. Residual urine signifi cantly decreased, resulting in a decreased incidence of urinary tract infections. In 2 patients upper tract dilatation resolved. In 3 patients rhizotomy was incomplete and higher sectioning of the roots was necessary. One implant had to be removed because of infection.Conclusions: The treatment of neurogenic bladder dysfunction in spinal cord injury by anterior sacral root stimulation with the Finetech-Brindley stimulator in combination with sacral poste rior root rhizotomy provides excellent results with limited morbidity.

Pudendal Nerve Stimulation and Block by a Wireless-Controlled Implantable Stimulator in Cats

“…The high-frequency biphasic PNS waveform generated by the implanted stimulator successfully blocked pudendal nerve conduction and eliminated the PNS-evoked EUS contraction when applied bilaterally on the pudendal nerves (Figs. [2][3][4][5]. The high-frequency biphasic PNS applied bilaterally at 10 kHz for 60 sec at locations Stim.…”

“…However, in the 1970s, Brindley and his team developed an implantable sacral anterior root stimulator to restore bladder function after SCI. This system is now commercially available (Finetech Medical Limited, Welwyn Garden City, Hertfordshire, UK) and has been implanted in more than 2000 SCI persons around the world (3). It requires sacral posterior root rhizotomy to prevent DO and DSD, which is destructive and irreversible and results in the loss of reflex sexual and defecation functions (3).…”

Low pressure voiding induced by a novel implantable pudendal nerve stimulator

“…2 In the 1970s, Dr. Brindley developed an implantable sacral anterior root stimulator to restore bladder functions after SCI. 3 However, this stimulator requires a sacral posterior root rhizotomy to eliminate NDO and DSD, 4 which also eliminates reflex sexual and defecation functions that are very important residual reflexes for SCI people.…”

Bladder and Sphincter Control after Spinal Cord Injury

“…This system is now commercially available (Finetech Medical, Wellyn Garden City, UK) and has been implanted in over 2000 people with SCI around the world. 2,3 It requires sacral posterior root rhizotomy to prevent detrusor sphincter dyssynergia in order to achieve the optimal result. 2,3 Although Brindley's method is the most successful treatment currently available to restore micturition after SCI, the sacral posterior root rhizotomy also disrupts reflex sexual and defecation functions and is irreversible.…”

“…2,3 Although Brindley's method is the most successful treatment currently available to restore micturition after SCI, the sacral posterior root rhizotomy also disrupts reflex sexual and defecation functions and is irreversible. 2,3 In the present mini-review, we present a new strategy to restore both continence and micturition by electrical stimulation and blockade of the pudendal nerves.…”