Neural Stimulation for Control of Voiding Dysfunction: A Preliminary Report in 22 Patients with Serious Neuropathic Voiding Disorders

Study design: Disturbance of gastrointestinal motility following acute spinal cord injury complicated with paraplegia can lead to bacterial overgrowth in the gastrointestinal tract, and increase the incidence of bacterial translocation. Experiments in a New Zealand rabbit model of acute spinal cord injury were performed. Objective: This study was designed to determine if the electrical stimulation of the sacral nerve prevents gut-origin bacterial translocation and endotoxemia in an animal model of acute spinal cord injury. Settings: Xiangya Hospital, Central South University, Hunan, PR China. Methods: New Zealand rabbits were divided into three groups: Control group, Paraplegic Vehicle group without sacral nerve stimulation and Paraplegic Experiment group with sacral nerve stimulation. Blood and multiple organs were collected for bacterial cultures and endotoxin determination at 24, 48 and 72 h following spinal cord injury. The histology and ultra-structural features of the organs were studied. Results: Bacterial translocation and endotoxemia were observed in all animals with acute spinal cord injury. Sacral nerve stimulation increased defecation, decreased endotoxin levels and bacterial translocation and improved the morphology of the organs. Conclusion: After acute spinal cord injury, stimulation of the sacral nerve reduced gut bacterial translocation and endotoxemia.

Section: Introductionmentioning

confidence: 99%

Stimulation of the sacral nerve reduces gut bacterial translocation and endotoxemia caused by acute spinal cord injury in rabbits

et al. 2010

“…Sacral anterior root stimulators of a different kind have been implanted in San Francisco since 1982.9, 10 The first 50 patients to receive implants designed in the MRC Neurological Prosthesis Unit were reviewed in 1985. 11 We here describe the state of these first 50 patients.…”

mentioning

confidence: 99%

Long-term follow-up of patients with sacral anterior root stimulator implants

Brindley¹,

Rushton²

1990

110

SummaryThe first 50 patients to receive a sacral anterior root stimulator for bladder control were reviewed by questionnaire in mid-1989. At that time, the follow-up period varied from 5 to 11 years, and 48 of the group were alive; 2 had died from unrelated causes. Forty-one used their implants regularly for micturition and of these, 37 were always or usually continent. Twenty-nine reported no symptomatic urinary infections in the previous year, and only 4 had 3 infections or more. Twenty-seven used their implant to assist defaeca tion, and 13 of 32 male users reported full implant-driven erections.Side effects are minor, except for stimulus evoked pain sensation, which prevents use of the implant in 3 of the 7 non-users. Two of the other non-users were awaiting repair of their implant faults.

“…13 Un fortunately, at the present time it is impos sible to predict which patients will lose erectile function. Careful preoperative con sent is clearly necessary.…”

Section: Discussionmentioning

confidence: 99%

Bladder rehabilitation with dorsal rhizotomy and ventral neuroprosthesis

Baskin

Schmidt

1992

Two patients with severe neuropathic bladders were successfully treated with selective dorsal rhizotomy in conjunction with a ventral root neuroprosthesis. Both patients achieved stabilization of their renal function, continence, resolu tion of vesicoureteral reflux, and relief from indwelling urethral catheters. This alternative form of management avoids the complications of other operative approaches.