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Related Experiment Videos

Experience with the Brindley anterior sacral root stimulator.

L Q Robinson1, A Grant, P Weston

  • 1Department of Urology, Cardiff Royal Infirmary, Sheffield.

British Journal of Urology
|December 1, 1988
PubMed
Summary

Brindley anterior sacral root stimulators improved continence in 68% of spinal cord injury patients using the implant. However, challenges with usage frequency and lower limb spasms affected outcomes.

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Area of Science:

  • Neuroscience
  • Urology
  • Rehabilitation Medicine

Background:

  • Spinal cord injury (SCI) frequently leads to bladder dysfunction and incontinence.
  • Anterior sacral root stimulation (ASRS) offers a potential therapeutic option for managing neurogenic bladder in SCI patients.

Purpose of the Study:

  • To evaluate the efficacy and outcomes of Brindley anterior sacral root stimulator implantation in spinal cord injured patients.
  • To assess the impact of ASRS on urinary continence, detrusor/sphincter dyssynergia, upper tract status, and erectile function.

Main Methods:

  • Implantation of Brindley anterior sacral root stimulators in 22 spinal cord injured patients (20 men, 2 women; 15 paraplegic, 7 tetraplegic).
  • Assessment of urinary continence, implant usage frequency, detrusor/sphincter dyssynergia management (including sphincterotomy), upper urinary tract status, and erectile function post-implantation.

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Main Results:

  • 16 out of 22 patients used the implant, achieving continence in 11 (68%).
  • Incontinence persisted in 4 patients due to infrequent implant use; 6 patients did not use the implant, with 4 remaining continent.
  • Sphincterotomy was required in 3 patients pre-implantation and 3 post-implantation for detrusor/sphincter dyssynergia. Upper tract issues were observed in 4 patients, with mixed resolution and deterioration.
  • Erectile function was clinically adequate in 6 patients, but intercourse was not achieved due to lower limb spasms.

Conclusions:

  • Brindley ASRS demonstrates significant potential for improving urinary continence in spinal cord injury patients.
  • Optimizing implant usage frequency and managing concurrent issues like detrusor/sphincter dyssynergia and lower limb spasms are crucial for successful outcomes.
  • Further research is needed to address limitations and enhance functional recovery in SCI patients undergoing ASRS.