Neurostimulation, Neuromodulation and Neurotization in the Therapy of Neurogenic Bladder

Česká verzia

Authors: Z. Mackerle ¹; E. Brichtová ¹; P. Zerhau ²; E. Göpfert ³; D. Sochůrková ¹; M. Husár ²; R. Jančálek ^1,4
Authors place of work: Neurochirurgická klinika LF MU a FN U sv. Anny v Brně ¹; Urologické oddělení při KDCHOT, FN Brno ²; Výzkumný ústav veterinárního lékařství, v. v. i., Brno ³; Mezinárodní centrum klinického výzkumu, FN u sv. Anny v Brně ⁴
Published in the journal: Cesk Slov Neurol N 2015; 78/111(1): 83-87
Category: Short Communication

Summary

A great number of patients with spinal cord dysfunction of various origin suffer from functional micturition disorders called neurogenic bladder. Most of the therapeutic regimens are aimed at providing adequate urine derivation to prevent upper urinary tract dysfunction. The method of choice is a permanent autocatheterization with pharmacological and surgical facilitation to decrease intravesical pressure. This is the reason for growing tendency to develop methods that would enable spontaneous micturition without the need for further medication. Neurostimulation or neuromodulation of sacral roots, pudendal or tibial nerve are the most prevalent methods. Indirect stimulation of the bladder can be accomplished with electrodes attached to the sacral roots or the pudendal nerve. Neuromodulation is performed by stimulation of the dorsal sacral nerve roots, pudendal nerve or percutaneous stimulation of the tibial nerve. Physiological alternative of the above mentioned stimulation might be neurorrhaphy with the use of persisting functional peripheral nerves or nerve roots as donors. The authors are comparing both methods of stimulation and neurotization based on the literature and animal experiments and outline the neurophysiological basis for potential solutions.

Key words:
neurogenic bladder – neurorrhaphy – neuromodulation – neurostimulation – arteficial voiding reflex arch

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

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