ELECTRICALLY STIMULATED DETRUSOR MYOPLASTY
2000; Lippincott Williams & Wilkins; Volume: 164; Issue: 3 Part 2 Linguagem: Inglês
10.1016/s0022-5347(05)67228-x
ISSN1527-3792
AutoresJohn G. Van Savage, Gustavo Perez‐Abadia, L G Palanca, Janou W. J. M. Bardoel, Thomas Harralson, Bruce L. Slaughenhoupt, Martin M. Palacio, Gordon R. Tobin, Claudio Maldonado, John H. Barker,
Tópico(s)Tissue Engineering and Regenerative Medicine
ResumoNo AccessJournal of UrologyNeurogenic Bladder1 Sep 2000ELECTRICALLY STIMULATED DETRUSOR MYOPLASTY JOHN G. VAN SAVAGE, GUSTAVO P. PEREZ-ABADIA, LUCIO G. PALANCA, JANOU W. BARDOEL, THOMAS HARRALSON, BRUCE L. SLAUGHENHOUPT, MARTIN M. PALACIO, GORDON R. TOBIN, CLAUDIO MALDONADO, and JOHN H. BARKER JOHN G. VAN SAVAGEJOHN G. VAN SAVAGE More articles by this author , GUSTAVO P. PEREZ-ABADIAGUSTAVO P. PEREZ-ABADIA More articles by this author , LUCIO G. PALANCALUCIO G. PALANCA More articles by this author , JANOU W. BARDOELJANOU W. BARDOEL More articles by this author , THOMAS HARRALSONTHOMAS HARRALSON More articles by this author , BRUCE L. SLAUGHENHOUPTBRUCE L. SLAUGHENHOUPT More articles by this author , MARTIN M. PALACIOMARTIN M. PALACIO More articles by this author , GORDON R. TOBINGORDON R. TOBIN More articles by this author , CLAUDIO MALDONADOCLAUDIO MALDONADO More articles by this author , and JOHN H. BARKERJOHN H. BARKER More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67228-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Many children with spina bifida and other causes of neurogenic bladder rely on clean intermittent catheterization to empty the hyporeflexic or areflexic bladder. Direct bladder and sacral nerve root stimulation have been met with limited success. We studied the electrical stimulation of a rectus abdominis muscle flap wrapped around the bladder to achieve bladder contractility and emptying. Materials and Methods: The feasibility of performing rectus detrusor myoplasty in humans was first studied in 8 cadavers. In male and female cadavers it was possible to wrap the distended bladder completely with the rectus abdominis muscle. The rectus abdominis muscle was surgically dissected with preservation of its insertion on the pubis bone and rotation of its mid section behind the bladder to effect a complete bladder wrap. The deep inferior epigastric artery and veins, and 2 most caudal intercostal nerves were preserved. This unilateral rectus abdominis muscle flap was then electrically stimulated with 2 pairs of bipolar electrodes inserted into the muscle near the nerve entrance. Stimulation frequencies of 40, 60 and 80 Hz. were used in each of the 8 dogs. The increase in intravesical pressure over baseline, compliance and post-void residual were measured. Paired Student’s t tests were used for statistical comparisons. Results: The increase in intravesical pressure ranged 35 ± 5 to 45 ± 7 cm. H2O at stimulation frequency 40 and 80 Hz., respectively. Post-void residual was 27 ± 4%, 22 ± 3% and 26 ± 3% at stimulation frequencies 40, 60 and 80 Hz., respectively. Intravesical pressure was significantly increased over baseline bladder pressure (p <0.05). Conclusions: Electrically stimulated detrusor myoplasty results in uniform increases in intravesical pressure and reasonable bladder emptying in an animal model. We are currently investigating detrusor myoplasty in a chronic study to determine whether it can be used for enhanced bladder emptying in children with poor detrusor contractility. References 1 : Electronic stimulation of the human bladder: 9 years later. J Urol1975; 113: 341. Link, Google Scholar 2 : Intraspinal sacral root stimulation for controlled micturition. Invest Urol1977; 15: 78. Google Scholar 3 : Urinary bladder and sphincter responses to stimulation of dorsal and ventral sacral roots. Invest Urol1979; 16: 300. Google Scholar 4 : Electrical stimulation of sacral roots for micturition after spinal cord injury. Urol Clin North Am1993; 20: 505. 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BARDOEL More articles by this author THOMAS HARRALSON More articles by this author BRUCE L. SLAUGHENHOUPT More articles by this author MARTIN M. PALACIO More articles by this author GORDON R. TOBIN More articles by this author CLAUDIO MALDONADO More articles by this author JOHN H. BARKER More articles by this author Expand All Advertisement PDF downloadLoading ...
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