An experimental study of artificial murine bladder reflex arc established by abdominal reflex

Area of Science:

• Neuroscience
• Surgical Innovation
• Urology

Background:

• Spinal cord injury frequently causes neurogenic bladder dysfunction, posing significant clinical challenges.
• Current treatments for neurogenic bladder are limited in efficacy.
• Restoring bladder function after spinal cord injury remains a critical unmet medical need.

Purpose of the Study:

• To establish an artificial bladder reflex arc in rats.
• To reinnervate the neurogenic bladder using an abdominal reflex pathway.
• To restore bladder micturition function following spinal cord injury.

Main Methods:

• Intradural microanastomosis of the right T13 ventral root to the S2 ventral root using autogenous nerve grafting.
• Assessment of long-term reflex arc function via electrophysiological data and intravesical pressure tests over 8 months.
• Horseradish peroxidase (HRP) tracing to confirm the effectiveness of the artificial reflex pathway.

Main Results:

• Stimulation of the right T13 dorsal root evoked action potentials, increased intravesical pressures, and generated bladder smooth muscle compound action potentials.
• HRP-labeled cells were observed in the T13 ventral horn and L6-S4 intermediolateral nucleus, confirming neural pathway reconstruction.
• Successful demonstration of a functional artificial reflex arc in rats post-spinal cord transaction.

Conclusions:

• Reconstructing the bladder's autonomous reflex arc using a surviving somatic reflex above the spinal cord injury level is feasible in rats.
• The technique involves intradural microanastomosis of ventral roots with autologous nerve grafting.
• This innovative approach holds potential for clinical applications in treating human neurogenic bladder.