Publication details

Neurostimulace, neuromodulace a neurotizace v terapii neurogenního močového měchýře

Title in English Neurostimulation, Neuromodulation and Neurotization in the Therapy of Neurogenic Bladder
Authors

MACKERLE Zdeněk BRICHTOVÁ Eva ZERHAU Pavel GÖPFERT E. SOCHŮRKOVÁ D. HUSÁR Matej JANČÁLEK Radim

Year of publication 2015
Type Article in Periodical
Magazine / Source Česká a Slovenská neurologie a neurochirurgie
MU Faculty or unit

Faculty of Medicine

Citation
Field Neurology, neurosurgery, neurosciences
Keywords neurogenic bladder; neurorrhaphy; neuromodulation; neurostimulation; arteficial voiding reflex arch
Description 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.

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