Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. Part I: Clinical and urodynamic analysis. Dutch Study Group on Sacral Anterior Root Stimulation.
OBJECTIVE
To present the clinical and urodynamic results of the treatment of neurogenic bladder dysfunction in spinal cord injury by sacral rhizotomies and electrical bladder stimulation with the Finetech-Brindley stimulator during a 3-year inclusion and study period.


METHODS
226 patients with spinal cord lesion and urological problems due to hyperreflexia of the bladder were screened for sacral rhizotomies and electrical bladder stimulation. In 52 patients complete posterior sacral root rhizotomies were performed and a Finetech-Brindley sacral anterior root stimulator implanted. All patients were screened and followed with a standard protocol.


RESULTS
Complete continence during daytime was achieved in 73% of patients with 6-month follow-up and in 86% at night. Significant increase in bladder capacity and bladder compliance was achieved in all patients. Residual urine was reduced significantly, resulting in a decrease of the incidence of urinary tract infections.


CONCLUSIONS
The treatment of neurogenic bladder dysfunction in spinal cord injury by anterior sacral root stimulation with the Finetech-Brindley stimulator in combination with sacral posterior root rhizotomy produces excellent results with limited morbidity.
Van Kerrebroeck
E V
EV
Department of Urology, University Hospital St. Radboud, Nijmegen, The Netherlands.
van der Aa
H E
HE
Bosch
J L
JL
Koldewijn
E L
EL
Vorsteveld
J H
JH
Debruyne
F M
FM
D000293:Adolescent; D000328:Adult; D003131:Combined Modality Therapy; D003404:Creatinine / Q000652:urine; D003672:Defecation / Q000502:physiology; D004558:Electric Stimulation; D004567:Electrodes, Implanted; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008160:Lumbosacral Plexus / Q000502:physiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010410:Penile Erection / Q000502:physiology; D011183:Postoperative Complications; D019051:Rhizotomy; D013035:Spasm; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology*; D016896:Treatment Outcome; D001745:Urinary Bladder Diseases / Q000601:surgery / Q000628:therapy*; D014549:Urinary Incontinence / Q000601:surgery / Q000628:therapy*; D014567:Urography
D003404:Creatinine