title: Transfer of normal S1 nerve root to reinnervate atonic bladder due to conus medullaris injury.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Orthopedic Surgery, Changzheng Hospital, The Second Military Medical University, Fengyang Road 415, Shanghai 200003, People's Republic of China.
authors.forename: Haodong
authors.initials: H
authors.lastname: Lin
authors.forename: Chunlin
authors.initials: C
authors.lastname: Hou
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016067:Nerve Transfer / Q000379:methods*; D013119:Spinal Cord Injuries / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D013126:Spinal Nerve Roots / Q000601:surgery*; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000503:physiopathology / Q000601:surgery*; D001750:Urinary Bladder, Neurogenic / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*