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Following experimental investigations, the authors have performed bladder stimulator implantation for paralyzed bladder patients since 1969. Up to 1983 altogether 32 operations were carried out for bladder paralysis following 21 peripheral and 11 central neural lesions. The patients urinated without residue after the operation. The observations showed that regular use of the stimulator led to the elimination of reflux in patients who had vesicoureteral reflux before the operation. It was found that, if the stimulator had to be removed for any reason after a period of 1 or 2 years, the urinating ability was maintained. Of the 7 female patients operated, 2 became pregnant. During pregnancy and delivery, the patients did not experience any problem with the implanted stimulator, and the children were born healthy and at term.

Authors performed electronic stimulation of the paralysed bladder that was attributed to various innervation troubles. For this purpose, they implanted 10 patients with stimulator Model PMS-3, each with 8 electrodes. In three cases, outside factors (like endocarditis, pyelonephritis aposthematosa, and progress of paralysis in the limbs) forced them to remove the stimulator. The other cases can be declared as successful, for complete bladder emptying has been obtained. The authors want to emphasize that patients with an implanted stimulator can dispense with an indwelling catheter thereby avoiding vesicoureteral reflux. The absence of recurrent pyelonephritis results in prolonged health. This new technique seems to be appropriate, especially in peripheric paralysis, while central paralysis connected with fibrosis of the bladder neck often requires additional surgical intervention, e.g., transurethral resection.

Between 1989 and 1992, 116 patients suffering from bladder tumours had been treated with Nd-Yag laser. In 74 cases only laser treatment was applied, in 42 cases laser treatment was combined with transurethral resection (TUR). The patients were in phases Ta, T1 or T2 and in the majority of them histological examination did not reveal Grade 3. No considerable complications, e.g. perforation of the bladder or severe haemorrhages, were observed during laser treatment. After laser and TUR+laser treatment, respectively, relapses occurred in 16-19% of the cases, considerably less frequently than after treatment with only TUR.

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