Reconstruction of atonic bladder innervation after spinal cord injury: A bladder reflex arc with afferent and efferent pathways

The Journal of Spinal Cord Medicine, 2015 · DOI: 10.1179/2045772314Y.0000000285 · Published: November 1, 2015

Spinal Cord Injury Urology Regenerative Medicine

Simple Explanation

Spinal cord injuries can lead to an atonic bladder, causing severe urinary retention and other complications. Current treatments have limitations, particularly the lack of sensory feedback. This study aimed to reconstruct a bladder reflex arc with both sensory (afferent) and motor (efferent) pathways. This reconstruction used microanastomosis to connect specific nerve roots and ganglia to re-establish bladder innervation. The results showed successful reconstruction of nerve pathways and improved bladder function in rats after spinal cord injury. The procedure did not greatly affect the motion of the leg.

Study Duration

3 Months

Participants

20 Sprague-Dawley male rats

Evidence Level

Not specified

Key Findings

1
The study successfully reconstructed a bladder reflex arc with both afferent and efferent pathways in rats with spinal cord injury.
2
Electrophysiological studies confirmed the presence of compound action potentials and compound muscle action potentials, indicating successful nerve regeneration and function.
3
WGA–HRP tracing and CGRP immunocytochemistry showed that the reconstructed reflex arc facilitated axonal regeneration and re-established axoplasmic transportation in both sensory and motor nerves.

Research Summary

This study aimed to reconstruct a bladder reflex arc with both afferent and efferent pathways to achieve atonic bladder innervation after SCI. The bladder reflex arc with afferent and efferent pathways reconstructs the micturition function without great influence on the motion of leg. The new approach may show considerable positive clinical prospects for SCI patients with atonic bladder.

Practical Implications

Potential clinical application

This approach may offer a new therapeutic avenue for spinal cord injury patients suffering from atonic bladder, potentially restoring bladder control and sensation.

Avoidance of DREZ inhibition

The study's method of using the peripheral process avoids the inhibitory effects of the dorsal root entry zone (DREZ) on nerve regeneration.

Preservation of leg motor function

The reconstruction of the bladder reflex arc had minimal impact on the motion of leg.

Study Limitations

1
The study could not quantitatively evaluate sensory function recovery in the animal model.
2
The rat model used may not completely align with clinical practice, potentially influencing the translatability of the results.
3
The study did not comprehensively address detrusor sphincter dyssynergia, a key problem after SCI.

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