Radiofrequency Sacral Rhizotomy for the Management of Intolerable Neurogenic Bladder in Spinal Cord Injured Patients

Annals of Rehabilitation Medicine, 2012 · DOI: 10.5535/arm.2012.36.2.213 · Published: April 1, 2012

Spinal Cord Injury Urology Rehabilitation

Simple Explanation

This study investigates using radiofrequency (RF) sacral rhizotomy to treat neurogenic bladder in spinal cord injury patients, where conventional treatments like anticholinergic drugs have failed to control urinary incontinence. The RF procedure involves ablating the sacral nerves (S2, S3, S4) that control bladder function, aiming to reduce detrusor muscle pressure and increase bladder capacity, thereby decreasing urinary incontinence. The results showed that RF sacral rhizotomy effectively increased bladder capacity and reduced urinary incontinence in most patients, suggesting it is a valuable treatment option for managing neurogenic bladder in spinal cord injured individuals.

Study Duration

5 years (March 2006 to July 2011)

Participants

12 spinal cord injured patients (11 males and 1 female)

Evidence Level

Not specified

Key Findings

1
The study found that after RF sacral rhizotomy, bladder capacity increased in 9 out of 12 patients, indicating improved bladder function.
2
The amount of daily urinary incontinence decreased in 11 out of 12 patients after the RF procedure, showing a significant reduction in incontinence.
3
The mean maximal bladder capacity significantly increased from 292.5 ml to 383.3 ml (p<0.05), and the mean daily incontinent volume decreased from 255 ml to 65 ml (p<0.05).

Research Summary

This study evaluated the effectiveness of radiofrequency (RF) sacral rhizotomy in managing neurogenic bladder with uncontrolled incontinence in spinal cord injured patients who had not responded to conventional treatments. The results indicated that RF sacral rhizotomy led to a significant increase in bladder capacity and a decrease in urinary incontinence among the patients. The authors concluded that percutaneous RF sacral rhizotomy is a safe and valuable treatment option for neurogenic detrusor overactivity in SCI, with no reported areflexic bladder, sphincter dysfunction, or sexual complications.

Practical Implications

Clinical Practice

RF sacral rhizotomy can be considered as an effective alternative for managing neurogenic bladder in SCI patients when conventional treatments fail.

Patient Outcomes

Patients with neurogenic bladder may experience improved bladder capacity and reduced urinary incontinence through RF sacral rhizotomy, enhancing their quality of life.

Future Research

Further studies are needed to evaluate the long-term effects of RF sacral rhizotomy on detrusor pressure and compliance in patients with neurogenic detrusor overactivity.

Study Limitations

1
The study did not evaluate the long-term effects of detrusor pressure and compliance.
2
The sample size was relatively small (12 patients).
3
Long-term follow-up data was missing for some patients beyond one year post-procedure.

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