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Related Experiment Videos

Neurostimulation for bladder evacuation: is sacral root stimulation a substitute for microstimulation?

M Probst1, H J Piechota, M Hohenfellner

  • 1Department of Urology, University of California School of Medicine, San Francisco, USA.

British Journal of Urology
|April 1, 1997
PubMed
Summary

Selective sacral rootlet stimulation may enable bladder evacuation by targeting autonomic fibers, avoiding detrusor/sphincter dyssynergia. This neurostimulation approach spares somatic fibers, facilitating low-pressure voiding.

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Area of Science:

  • Neuroscience
  • Urology
  • Surgical Anatomy

Background:

  • Current neurostimulation for bladder evacuation often causes detrusor/sphincter dyssynergia.
  • Selective stimulation of autonomic fibers is desired to improve bladder evacuation techniques.

Purpose of the Study:

  • To investigate if selective stimulation of sacral rootlets can target autonomic fibers.
  • To avoid detrusor/sphincter dyssynergia in bladder evacuation neurostimulation.

Main Methods:

  • Anatomical and functional studies were performed in 10 male mongrel dogs.
  • The S2 sacral root and its rootlets were isolated and stimulated at various levels (intra- and extra-dural).

Main Results:

  • Sacral rootlets of the ventral S2 maintain distinct pathways within the dura.

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  • Rootlets were found to carry predominantly autonomic, somatic, or mixed fibers.

    • Conclusions:

    • Surgically identifying and severing predominantly somatic rootlets intradurally is feasible.
    • Sparing autonomic rootlets for extradural electrode placement can eliminate sphincteric interference.
    • This technique may enable low-pressure bladder voiding by promoting detrusor contraction without sphincter opposition.