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Related Experiment Videos

Sacral anterior root stimulation: prerequisites and indications

H Madersbacher1, J Fischer

  • 1University Hospital Innsbruck, Austria.

Neurourology and Urodynamics
|January 1, 1993
PubMed
Summary

Anterior sacral root stimulator (ASRS) implantation is suitable for patients with intact sacral reflex arcs, benefiting those with spinal cord injuries. Combining ASRS with posterior sacral root rhizotomy improves bladder function and quality of life.

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Area of Science:

  • Neuroscience
  • Urology
  • Rehabilitation Medicine

Background:

  • Implantation of an anterior sacral root stimulator (ASRS) requires specific prerequisites for successful outcomes.
  • Assessing detrusor contractility and sacral reflex arc integrity is crucial before considering ASRS.

Purpose of the Study:

  • To define the patient selection criteria for anterior sacral root stimulator (ASRS) implantation.
  • To evaluate the efficacy of ASRS, often in conjunction with posterior sacral root rhizotomy, for improving bladder function and quality of life.

Main Methods:

  • Patient suitability assessed via transrectal or direct needle electrostimulation of sacral roots.
  • Ideal candidates include complete midthoracic paraplegics; tetraplegics and those with incomplete lesions (with rhizotomy) also benefit.

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  • Myelomeningocele patients considered if sacral root anatomy permits; vesico-uretero-renal reflux is not a contraindication and may be an indication.

    • Main Results:

    • ASRS implantation, particularly when combined with posterior sacral root rhizotomy, normalized low compliance bladders and achieved continence in 30 patients.
    • The procedure significantly improved the quality of life for all patients in the series.
    • No patient reported regret following the operation, indicating high satisfaction and benefit.

    Conclusions:

    • Careful patient selection based on sacral reflex arc and detrusor function is key for successful ASRS implantation.
    • Combining ASRS with posterior sacral root rhizotomy is often necessary to optimize bladder compliance, control reflex voiding, and achieve continence.
    • ASRS offers a significant improvement in quality of life for carefully selected patients with neurogenic bladder dysfunction.