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Neuromicturition

Extradural sacral nerve-root stimulation: guidelines for patient selection and implant technique

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Summary

The neuroprosthetic approach for management of the spinal injury bladder is proving to be a valuable form of therapy. Stimulation of the ventral roots of S3–4, unilaterally or bilaterally, can effectively return control of bladder evacuation to a patient. The dorsal rhizotomy of the S2–4 nerves, performed at the same time as the electrode implant, has significant therapeutic benefit by itself. Bladder spasticity is reduced, which can correct reflux, restore continence, and decrease the risk of renal loss associated with urinary tract infection. Patients must be appropriately selected for the technique from a medical, psychological, urological and neurological point of view. Quality of life is greatly enhanced in these patients without significant risk. The following discussion addresses the evolution of and experience with the extradural method for implanting electrodes to control the spinal injury bladder.

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Authors and Affiliations

  1. Department of Urology, U-575, University of California, School of Medicine, 94143-0738, San Francisco, California, USA

    R. A. Schmidt & E. A. Tanagho

Authors
  1. R. A. Schmidt
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  2. E. A. Tanagho
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Schmidt, R.A., Tanagho, E.A. Neuromicturition. World J Urol 9, 114–121 (1991). https://doi.org/10.1007/BF00202504

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  • DOI: https://doi.org/10.1007/BF00202504

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