Restoration of the penile sensory pathway through end-to-side dorsal root neurorrhaphy in rats

The Journal of Spinal Cord Medicine, 2022 · DOI: 10.1080/10790268.2020.1778353 · Published: June 18, 2020

Spinal Cord Injury Urology Regenerative Medicine

Simple Explanation

This study explores a surgical technique to restore penile sensation in rats after spinal cord injury. The procedure involves connecting a severed nerve root to an adjacent intact nerve root to rebuild the sensory pathway. Researchers transected specific dorsal roots (DRs) and the dorsal nerve of the penis (DNP) in rats, then reconnected a severed DR to an intact one. They assessed nerve regeneration and function using various methods. The results showed that the surgical technique was feasible in rats, with signs of nerve regeneration and restored sensory pathways. However, the rats did not exhibit reflexive erections after the surgery.

Study Duration

4 Months

Participants

40 male adult Sprague–Dawley rats

Evidence Level

Not specified

Key Findings

1
Neural labeling tests indicated the integrity of the rebuilt penile afferent pathway, suggesting a successful reconnection of nerves.
2
Morphological studies, immunofluorescence, and ultrastructural observation showed better nerve regeneration in the group that received the nerve transfer compared to the resection group, but it did not reach the level of the control group.
3
Reflexive erection tests were negative in the nerve transfer group, indicating that the regenerated pathway did not fully restore erectile function.

Research Summary

This study investigated the feasibility of restoring the penile sensory pathway in rats with spinal cord injury using end-to-side dorsal root transfer neurorrhaphy. The results showed that the procedure was feasible, with evidence of nerve regeneration and reconnection of the sensory pathway. However, the regenerated pathway did not fully restore erectile function, suggesting the need for further research to optimize the technique.

Practical Implications

Surgical Technique Development

The study introduces a novel surgical method for potentially restoring penile sensory function after spinal cord injury, offering an alternative to peripheral nerve transfer.

Expanding Treatment Options

The dorsal root transfer technique may be suitable for patients with higher spinal cord injury levels, expanding the application scope of nerve transfer surgery.

Further Research Directions

The study highlights the need for further research to improve the functional outcomes of nerve transfer procedures, potentially combining surgery with neurotrophic factors or ventral root transposition.

Study Limitations

1
No functional experiments were performed to quantitatively analyze the recovery of PS in the rats.
2
The study used bilateral afferent nerve resection to simulate the loss of penile sensation after SCI, which differs from the actual situation of clinical patients.
3
The study did not describe the specific mechanism of neural regeneration induced by the procedure in the rats.

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