Our long-term goals are to develop surgical approaches to reinnervate the lower motor neuron-lesioned urinary bladder, urethra and anal sphincter. We have been highly successful in using a canine model to prove that somatic nerves can be rerouted to the anterior vesical branch of the pelvic nerve between the pelvic plexus and the bladder dome to reinnervate the bladder muscle. We found that electrical stimulation of these transferred nerves can increase detrusor pressure and induce bladder emptying, and confirmed regrowth of these rerouted nerves using retrograde tracing methods. The most clinically relevant overall question is does this reinnervation actually improve storage and emptying function in the awake animal? This will be addressed in the aims below by performing urodynamic studies, using implanted radiofrequency RF micro-stimulators and functional electrical stimulation FES of the rerouted nerves,25, 45, 46 on non-anesthetized animals at regular intervals as their bladders and urethral sphincters become reinnervated during a 6-month post-operative observation period.
Reinnervation of Urethral and Anal Sphincters With Femoral Motor Nerve to Pudendal Nerve Transfer
Female urethral diverticulum containing large calculi. Directory of Open Access Journals Sweden. Full Text Available Urinary stones in female urethral diverticulum are rarely seen. We report a year-old woman who presented with irritative lower urinary tract symptoms and vaginal cystocele with incontinence. The urethral stones in the diverticulum were successfully extracted through the trans- urethral route and anterior tension-free vaginal mesh was applied one month later. The patient has been well, with no lower urinary symptoms or incontinence for 4 months. Keywords: Female , Urethral diverticulum , Incontinence, Calculus.
Lower motor neuron damage to sacral roots or nerves can result in incontinence and a flaccid urinary bladder. We showed bladder reinnervation after transfer of coccygeal to sacral ventral roots, and genitofemoral nerves L1, 2 origin to pelvic nerves. This study assesses the feasibility of urethral and anal sphincter reinnervation using transfer of motor branches of the femoral nerve L2—4 origin to pudendal nerves S1, 2 origin that innervate the urethral and anal sphincters in a canine model.
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