Reconstruction of Afferent and Efferent Nerve Pathways of the Atonic Bladder

Chapter

Abstract

Restoration of normal micturition in SCI patients is a major goal in neuro-urology. The ideal therapy would be to achieve repair of the injured spinal cord, but this is not feasible at the present time. Thus, other procedures have been deployed, including intermittent catheterization, electrical stimulation of the sacral ventral roots, continence diversion and external sphincterotomy [1–3]. Unfortunately, these approaches have hardly led to satisfactory outcomes in the majority of SCI cases. Recently, Xiao et al. reported a series of experimental and clinical studies attempting to establish a “skin-central nervous system (CNS)-bladder” reflex pathway to trigger bladder contraction [4–6]. However, this technique was useful only in the cases of spastic bladder incurred by supraconal injuries. Clinically, fracture-dislocation of the spinal column was most commonly witnessed in the thoracolumbar region (T12/L1), This is more likely to result in damage to the spinal cone and bladder center, triggering hypotonia and decreased bladder contractile strength. This study was performed in an attempt to demonstrate that restoration of autonomic micturition in the atonic bladder by re-establishment of afferent and efferent nerve pathways is achievable.

Keywords

Compound Muscle Action Potential Ventral Root Nerve Graft Control Side Bladder Smooth Muscle 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.Department of Orthopedic SurgeryChangzheng Hospital, The Second Military Medical UniversityShanghaiPeople’s Republic of China

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