Haodong Lin1, Chunlin Hou. 1. Department of Orthopedic Surgery, Changzheng Hospital, The Second Military Medical University, Fengyang Road 415, Shanghai 200003, People's Republic of China.
Abstract
INTRODUCTION: Neurogenic bladder dysfunction after spinal cord injury (SCI) is a major medical and social problem. In this study we assessed the effectiveness of neurogenic bladder reinnervation in patients with SCI using a normal S1 nerve root. METHODS: Nine patients with bladder dysfunction caused by injury to the low conus medullaris (S2-S5) underwent a novel surgical procedure in which the unilateral proximal end of the S1 ventral root (VR) was anastomosed to the distal end of the S2 and S3 VRs. RESULTS: Seven patients regained satisfactory bladder control within 8-12 months after VR microanastomosis. The average residual urine volume decreased from 186.0 ± 35.0 ml to 43.0 ± 10.0 ml, and no urinary infections occurred. CONCLUSIONS: These results suggest the effectiveness of bladder innervation by S1 nerve transfer, which could provide a new approach for the reconstruction of atonic bladder function caused by low conus medullaris injuries.
INTRODUCTION:Neurogenic bladder dysfunction after spinal cord injury (SCI) is a major medical and social problem. In this study we assessed the effectiveness of neurogenic bladder reinnervation in patients with SCI using a normal S1 nerve root. METHODS: Nine patients with bladder dysfunction caused by injury to the low conus medullaris (S2-S5) underwent a novel surgical procedure in which the unilateral proximal end of the S1 ventral root (VR) was anastomosed to the distal end of the S2 and S3 VRs. RESULTS: Seven patients regained satisfactory bladder control within 8-12 months after VR microanastomosis. The average residual urine volume decreased from 186.0 ± 35.0 ml to 43.0 ± 10.0 ml, and no urinary infections occurred. CONCLUSIONS: These results suggest the effectiveness of bladder innervation by S1 nerve transfer, which could provide a new approach for the reconstruction of atonic bladder function caused by low conus medullaris injuries.