Effect of lumbarsacral nerve root inosculation on the function of autonomous neurogenic bladder：an experimental study

English Keywords:Sacral medulla  Injure  Autonomous neurogenic bladder  Urinary dynamics  Dog

English Abstract:

  【Abstract】 Objective：To investigate the feasibility of lumbarsacral nerve inosculation on improvement of autonomous neurogenic bladder.Method：The urinary dynamics，including bladder volume，stress，strain and electromyography（EMG） of sphincter were undertaken in 10 domestic dogs as control prior to surgery.After that，2 dogs were sacrificed and their S1，S2 nerve root were harvested and their inner myelin and demyelin neurofibers were quantified by HE stain as control，the another 8 animals were processed into test group by inosculation of L4，L5 lumbar nerve roots and S1，S2 sacral nerve roots，the urinary dynamics were performed at 4 and 7 month after operation respectively，after that，the animals were sacrificed，the myelin and demyelin neurofibers at anastomotic site were quantified thereafter.Result：4 mouths after operation，animals in the test group showed distinct increasing of bladder volume and strain compared with the control（P<0.05），while the pressure of bladder and the EMG voltage of sphincter decreased distinctively（P<0.05）.7 mouths after operation，the pressure in bladder and the EMG voltage of sphincter showed no distinct decrease（P>0.05），while the bladder volume and strain increased remarkably（P<0.05），the demyelin neurofibers increased significantly（P<0.05），however the myelin neurofibrers decreases distinctively（P<0.05）.Conclusion：Inosculation of L4，L5 nerve roots and S1，S2 nerve roots can repair the urethra sphincter and bladder detrusor governed by S1，S2 nerve root，which can improve the autonomous neurogenic bladder due to injury to sacral cord and cone.