[Selective sacral nerve blockade in the treatment of detrusor hyperreflexia of the bladder]

Hyperreflexive detrusor instability causes severe impairment of the patients private and professional life. Involuntary detrusor contractions lead to incontinence. The results of previous pharmacological and operative therapeutic procedures are unsatisfactory. 22 cases with idiopathic hyperreflexive detrusor instability were cured by selective local anaesthesia of both sacral roots S3. The follow-up period ranges from 4 months to 2 years. In case with neurogenic detrusor instability local anaesthesia of the sacral roots S3 has no permanent effect. But in 4 such cases it was possible to reach continence by permanent interruption of the roots S3 using phenolglycerin injections. Unavoidably this success, which enables social rehabilitation, results in voiding disturbance of the bladder which makes voiding by manual bladder compression or even catheterization necessary.