High Frequency Sacral Root Nerve Block Allows Bladder Voiding
Neurourol Urodyn, 2012 · DOI: 10.1002/nau.21075 · Published: June 1, 2012
Simple Explanation
Following spinal cord injury, uncoordinated bladder and sphincter activity can prevent voiding. This study investigates whether blocking nerve conduction in the sacral roots using kilohertz frequency (KF) electrical stimulation can prevent sphincter activation and allow bladder voiding. The S2 sacral nerve roots were stimulated to generate bladder pressure, while one S1 nerve root was stimulated to evoke EUS pressure, simulating dyssynergic reflexes. KF waveforms were applied to an electrode implanted on the S1 nerve root to block nerve conduction. The study found that applying KF waveforms increased bladder voiding, suggesting that sacral nerve block can prevent EUS activation and allow complete bladder voiding, potentially eliminating the need for surgical neurotomy.
Key Findings
- 1Applying KF waveforms increased bladder voiding in single trials from 3 ± 6% to 59 ± 12%.
- 2Voiding could be increased to 82 ± 9% of the initial bladder volume by repeating or increasing the duration of the trials.
- 3Bladder voiding during KF stimulation was equivalent to unobstructed bladder voiding.
Research Summary
Practical Implications
Improved Neuroprosthetics
Sacral nerve block can be used in bladder voiding neuroprostheses, potentially eliminating the need for a neurotomy.
Reduced Morbidity
Eliminating neurotomy requirements could increase patient acceptance of bladder voiding neuroprostheses.
Reduced Healthcare Costs
Increasing patient acceptance of bladder voiding neuroprostheses could reduce the cost of patient care.
Study Limitations
- 1Block could not be achieved in one animal.
- 2Sacral stimulation evoked minimal bladder pressure in one animal, prevented voiding although EUS block was complete.
- 3The remaining animal did not void during Max Voiding trials due to a urethral obstruction despite sufficient bladder pressure, even under deep anesthesia.