Long‐term course of sacral anterior root stimulation in spinal cord injured individuals: The fate of the detrusor. Issue 6 (24th October 2016)

• Record Type: Journal Article
• Authors: Krebs, Jörg; Wöllner, Jens; Grasmücke, Dennis; Pannek, Jürgen
• Is Part Of: Neurourology and urodynamics. Volume 36:Issue 6(2017:Aug.)
• Page Start: 1596
• Page End: 1600
• Publication Date: 2016-10-24
• Subjects: detrusor pressure -- neurogenic lower urinary tract dysfunction -- sacral anterior root stimulation -- sacral deafferentation -- spinal cord injury -- urodynamics; Urinary organs -- Periodicals; Urodynamics -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1002/nau.23161
• Languages: English
• ISSNs: 0733-2467

Abstract

Abstract : Aims: To investigate the long‐term course of the detrusor pressure during sacral anterior root stimulation in spinal cord injury (SCI) patients. Methods: Retrospective evaluation of 111 patients who had undergone sacral deafferentation and implantation of an anterior root stimulator at a single SCI rehabilitation center with a minimum follow‐up time of 5 years. Results: The median follow‐up time was 11.7 years (range 5.0‐24.9 years). The maximum detrusor pressure (Pdet_max) during stimulation was higher in men compared to women ( P = 0.0004) and decreased over time ( P = 0.0006). However, there were no significant ( P ≥ 0.06) differences in the median Pdet_max during stimulation between the first measurement time point and any follow‐up time point. The Pdet_max during stimulation decreased from 62 cmH2 O (95%CI 57‐73 cmH2 O) to 53 cmH2 O (95%CI 47‐69 cmH2 O) ( P = 0.9). The time had also a significant effect on Pdet_max during the storage phase ( P < 0.0001) and bladder compliance ( P = 0.0007). The Pdet_max during the storage phase decreased, whereas bladder compliance increased during the follow‐up period. There were no significant ( P ≥ 0.1) changes over time in bladder capacity, the number of daily stimulations and the residual urine volume after voiding. Conclusions: The detrusor pressure during sacral anterior root stimulation decreases over time in SCI individuals. However, the changes do not seem to be clinically relevant during the first decade after surgery.