Selective detrusor activation by electrical sacral nerve root stimulation in spinal cord injury.

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作   者：

Rijkhoff NJ;  Wijkstra H;  van Kerrebroeck PE;  Debruyne FM; 

作者机构：

The Netherlands.;  University Hospital Nijmegen;  Department of Urology; 

关键词：

膀胱;  脊神经根;  电刺激疗法;  Spinal Cord Injuries;  脊髓损伤;  Bladder;  Spinal Nerve Roots;  Electric Stimulation Therapy;  排尿障碍;  尿道; 

期刊名称：

The Journal of Urology

i s s n：

0022-5347

年卷期：

1997 年 157 卷 4 期

页   码：

1504-1508

页   码：

摘   要：

Electrical sacral nerve root stimulation can be used in spinal cord injury patients to induce urinary bladder contraction. However, existing stimulation methods activate simultaneously both the detrusor muscle and the urethral sphincter. Urine evacuation is therefore only possible using poststimulus voiding. Micturition would improve if the detrusor muscle could selectively be activated. The purpose of this study was to demonstrate selective detrusor activation in patients by ventral sacral root stimulation. The stimulation method involves selective activation of the small diameter myelinated nerve fibers and consists of a combination of cathodal excitation and selective anodal blocking using a tripolar electrode. To investigate anodal blocking, the intraurethral pressure response to stimulation was measured in acute experiments performed on 12 patients. The influence of both pulse amplitude and pulse duration on the pressure response was analyzed. In 8 out of 12 patients anodal blocking of somatic motor fibers was possible. This study also indicates the feasibility of selective detrusor activation by sacral root stimulation.