Urodynamic observations on patients with sacral anterior root stimulators

Area of Science:

• Neuroscience
• Urology
• Biomedical Engineering

Background:

• Spinal cord injuries often result in severe bladder dysfunction, including poor control and large residual volumes.
• Current management strategies for neurogenic bladder can be invasive or have limited efficacy.

Purpose of the Study:

• To evaluate the urodynamic effects and clinical outcomes of sacral anterior root stimulator (SURS) implantation in patients with spinal injuries.
• To assess the impact of SURS on bladder capacity, voiding efficiency, continence, and associated complications.

Main Methods:

• A cohort of 13 patients with spinal injuries and detrusor sphincter dyssynergia underwent SURS implantation.
• Pre- and post-operative urodynamic assessments, including videocysto-urethrography, pressure, and flow studies, were conducted over a 6-month to 5-year follow-up period.

Main Results:

• All patients demonstrated a significant reduction in residual bladder volume (<50 ml) and an increase in functional bladder capacity.
• Patients achieved voluntary, controlled voiding via implant activation, resulting in normal voiding pressures and acceptable flow rates.
• Significant improvements were observed in vesico-ureteric reflux and bladder trabeculation; 9/13 patients achieved nighttime continence, and 8/13 achieved daytime continence.

Conclusions:

• Sacral anterior root stimulation is an effective treatment for neurogenic bladder in spinal injury patients, restoring bladder control and improving continence.
• SURS implantation offers a viable therapeutic option for managing complex bladder dysfunction secondary to spinal cord injury.
• The technology facilitates voluntary voiding and significantly enhances the quality of life for affected individuals.