Sacral Anterior Root Stimulation of the Bladder in Paraplegics

Arnold, E. P.; Gowland, Shannon; MacFarlane, Martin R.; Bean, Alan; Utley, W. L. F.

doi:10.1111/j.1445-2197.1986.tb06156.x

Cited by 19 publications

(3 citation statements)

References 7 publications

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“…Insufficiency of kidney function is also sometimes encountered. Treatment of the neurogenic bladder with a Brindley Bladder Controller gives both good short term results (Arnold et al, 1986;Brindley et al, 1986;Madersbacher et al, 1988) and long term results (Brindley & Rushton, 1990;Brindley, 1994Brindley, , 1995.…”

Section: Discussionmentioning

confidence: 98%

“…Nowadays, through the development of a device designed by Brindley (Brindley et al, 1982Brindley 1986Brindley , 1991, electrical stimulation gives good results in the management of neurogenic dysfunction of the bladder. The device takes advantage of the different contraction and relaxation characteristics of the sphincter and bladder wall muscles (Arnold et al, 1986;Brindley et al, 1986;Madersbacher et al, 1988;Brindley & Rushton, 1990). Although the sacral anterior root stimulation initiates a simultaneous contraction of the detrusor and the sphincter muscles, it is possible to produce micturition because the striated muscle of the sphincter contracts and relaxes more rapidly than the smooth muscle of the detrusor.…”

Section: Introductionmentioning

confidence: 99%

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Sacral Anterior Root Stimulation for Bladder Control: Clinical Results

Alleman

Nene

et al. 1999

Archives of Physiology and Biochemistry

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The Brindley bladder stimulator delivers intermittent stimulation to the anterior sacral roots. The stimulus parameters can be adjusted and set specifically for individuals. Its primary purpose is to improve bladder emptying, thereby to eliminate urinary infection and to preserve kidney function. It also assists in defecation and enables male patients to have a sustained full erection. In our unit so far 38 patients with a complete spinal cord lesion have received a Brindley bladder stimulator implant. One patient died 2 weeks after the surgery due to pulmonary embolism. Two other patients died due to unrelated causes during the follow up period. They used their implants for less than 1 year. Results relating to these 2 patients and the remaining 35 patients who regularly use their implant are presented. The follow-up period ranged from 3 months to 12 years. Residual urine volumes are substantially reduced in all patients; in 24 patients the residual urine volume is less than 30 ml. All patients have increased bladder capacity. Thirty-one patients are continent. Out of 33 males 29 can achieve a sustained full erection using the stimulator. Twenty-seven patients use the implant for bowel function. The following complications were encountered: (1.) Cerebro-spinal fluid collection occurred around the implant in 3 patients during the post-operative period; (2.) Receiver failure occurred in 3 patients. A successful replacement with a new receiver block was carried out in these cases. It is concluded that the use of a bladder stimulator in selected patients gives long term favourable results.

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Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Sacral Anterior Root Stimulation for Bladder Control: Clinical Results

Alleman

Nene

et al. 1999

Archives of Physiology and Biochemistry

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“…Over 200 have now been implanted in 21 centres in Europe and four in Australasia. Reports include Arnold et al (1986), Herlant & Colombel (1986) and Varma et al (1986). Related stimu lators have been developed in San Francisco (Schmidt 1986) and Toronto (Tallala 1986).…”

Section: The Sacral Anterior Root Stimulatormentioning

confidence: 99%

The Ferrier Lecture, 1986: The actions of parasympathetic and sympathetic nerves in human micturition, erection and seminal emission, and their restoration in paraplegic patients by implanted electrical stimulators

Brindley¹

1988

Proc. R. Soc. Lond. B.

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Implants that stimulate the S2, S3 and S4 anterior roots improve micturition, defaecation and penile erection in many patients with spinal-cord injuries. The posterior rhizotomy that is commonly done at the same time usually cures their urinary incontinence, and may greatly improve bladder compliance. Implants that stimulate the hypogastric plexus allow semen to be obtained easily from some men with spinal injuries who cannot ejaculate, and may allow an implant-driven erection. A little new knowledge about the neurophysiology of the pelvic organs has come from studying the performance of these implants.

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Sacral anterior root stimulation for bladder control in patients with a complete lesion of the spinal cord

Hermens

Alleman³

et al. 1995

Acta neurochir

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A Finetech-Brindley bladder controller was implanted in 17 patients with a complete lesion of the spinal cord. During a microscopic procedure in the cauda equina, the sacral roots were identified and the posterior components of the S2, S3 and S4 roots were cut. The stimulator was placed intradurally around the anterior components of the S2, S3, S4 roots and the S5 root. Our patients have now been followed-up for periods varying between 1 and 6 years. In all 17 patients, the bladder capacity has been increased; 16 patients have a residual volume of less than 30 ml, urinary tract infection is rare; 12 patients are fully continent. All male patients can achieve a full sustained erection by means of the implant and 13 patients are using the implant for bowel function. The method has no significant harmful effects or complications.

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Sacral Anterior Root Stimulation of the Bladder in Paraplegics

Cited by 19 publications

References 7 publications

Sacral Anterior Root Stimulation for Bladder Control: Clinical Results

Sacral Anterior Root Stimulation for Bladder Control: Clinical Results

The Ferrier Lecture, 1986: The actions of parasympathetic and sympathetic nerves in human micturition, erection and seminal emission, and their restoration in paraplegic patients by implanted electrical stimulators

Sacral anterior root stimulation for bladder control in patients with a complete lesion of the spinal cord

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