Posterior sacral rhizotomy and intradural anterior sacral root stimulation for treatment of the spastic bladder in spinal cord injured patients.

Details

Serval ID
serval:BIB_372AA125CA63
Type
Article: article from journal or magazin.
Collection
Publications
Title
Posterior sacral rhizotomy and intradural anterior sacral root stimulation for treatment of the spastic bladder in spinal cord injured patients.
Journal
Journal of Urology
Author(s)
Schurch B., Rodic B., Jeanmonod D.
ISSN
0022-5347 (Print)
ISSN-L
0022-5347
Publication state
Published
Issued date
1997
Volume
157
Number
2
Pages
610-614
Language
english
Notes
Publication types: Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
PURPOSE: The efficacy of intradural sacral posterior rhizotomy combined with intradural sacral anterior root stimulation in the treatment of the neurogenic hyperreflexic bladder was evaluated.
MATERIALS AND METHODS: We reviewed 10 spinal cord injured patients who underwent surgery between September 1990 and February 1994. Bladder function was compared preoperatively and postoperatively. Intraoperative data on electrostimulation of the detrusor and striated muscles were analyzed.
RESULTS: Stimulation of the anterior S3 and S4 roots was mostly used to empty the bladder (7 of 10 cases). Preoperative reflex incontinence disappeared in all patients postoperatively. Mean postoperative bladder capacity increases and mean postoperative post-void residual decreases were at least 340 ml. (p < 0.01) and 140 ml. (p < 0.01), respectively. Preoperative vesicorenal reflux disappeared in 2 and improved in 3 cases after sacral deafferentation. Autonomic hyperreflexia, which was present preoperatively in 6 patients, never disappeared but significantly improved after deafferentation. No major complications were noted postoperatively.
CONCLUSIONS: Intradural sacral posterior rhizotomy combined with intradural sacral anterior root stimulation is a valuable method to treat the hyperreflexic bladder with incontinence resistant to conservative therapy in spinal cord injured patients. Autonomic hyperreflexia was decreased but not suppressed by posterior sacral rhizotomy.
Keywords
Adolescent, Adult, Combined Modality Therapy, Dura Mater, Electric Stimulation Therapy/methods, Female, Humans, Lumbosacral Plexus, Male, Rhizotomy/methods, Spasm, Spinal Cord Injuries/complications, Spinal Cord Injuries/physiopathology, Urinary Bladder, Neurogenic/etiology, Urinary Bladder, Neurogenic/physiopathology
Pubmed
Web of science
Create date
05/11/2014 13:12
Last modification date
03/03/2018 16:04
Usage data