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Related Experiment Video

Updated: Aug 26, 2025

Structured Motor Rehabilitation After Selective Nerve Transfers
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Restoring bladder function using motor and sensory nerve transfers: a cadaveric feasibility study.

Benjamin R Johnston1, Stanley Bazarek1, Margaret Sten2

  • 11Department of Neurosurgery, Brigham and Women's Hospital, Boston.

Journal of Neurosurgery. Spine
|October 8, 2022
PubMed
Summary

Nerve transfers can restore bladder function after low spinal cord injury. Donor nerves, including the obturator and vastus medialis, are sufficiently long and wide for successful surgical coaptation.

Keywords:
bladderdetrusor muscleincontinencemicturitionobturator nervesacral

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Area of Science:

  • Urology
  • Neuroscience
  • Surgical Innovation

Background:

  • Bladder dysfunction post-nerve injury presents variably as spastic or atonic.
  • Current treatments are limited, especially for sacral nerve root injuries with preserved lumbar function.

Purpose of the Study:

  • To evaluate the feasibility of specific nerve transfers for restoring bladder and urethral function.
  • To measure donor nerve length and diameter for tensionless anastomosis in cadaveric dissections.

Main Methods:

  • Dissection of 26 pelvic and thigh regions in 13 female cadavers.
  • Identification and measurement of donor nerves (obturator, vastus medialis, saphenous) and recipient pelvic nerves.
  • Assessment of nerve lengths and diameters for tensionless coaptation.

Main Results:

  • The posterior obturator nerve could be transferred to the pelvic nerve's vesical branch with excess length (2.0 ± 1.2 cm).
  • Distances from femoral nerve arborization to relevant pelvic landmarks were measured (e.g., 12.9 ± 1.4 cm to ischial spine).
  • Donor and recipient nerve diameters were found to be similar.

Conclusions:

  • Proposed donor nerves possess adequate length and caliber for tensionless anastomosis.
  • These nerve transfers are anatomically feasible for reconstructing bladder and urethral innervation in select spinal cord injury cases.