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Cited by 313Urinary Bladder and Prostate ResearchSpinal Cord Injury ResearchPelvic floor disorders treatments

Sacral anterior root stimulators for bladder control in paraplegia: the first 50 cases

Open access
Brindley, G S, Polkey, C E, Rushton, D N, Cardozo, L·1986·Journal of Neurology, Neurosurgery & Psychiatry
DOI 10.1136/jnnp.49.10.1104PMC PMC1029041
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Abstract

The first 50 patients who have received sacral anterior root stimulator implants are presented, with follow-up of from 1 to 9 years. Forty-nine are alive and 43 are regularly using their implants for micturition. Of the 49 living, 39 are "very pleased, without significant reservations", six are pleased on balance but have reservations, and four are dissatisfied. Residual urine volumes are substantially reduced in all patients who are using their implants. Ten of the 12 female patients and the majority of male patients have become continent. The voiding pressure in implant-driven micturition can be regulated by adjusting the stimulus parameters, and is always kept below 90 cm H2O. Of seven patients with ureteric reflux before operation, four have ceased to reflux and the other three are unchanged. Changes in the radiographic appearances of the bladder have been favourable or zero, but there have been two cases of deterioration in the upper urinary tracts. Significant harmful effects have been CSF leaks, urinary infections following post-operative urodynamic study, and accidental damage to roots. Anterior roots nearly always recover from accidental damage, and posterior roots do not.

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Crossref · 10.1136/jnnp.49.10.1104

Cites

15 of 15 references verified0 citation errors · 0 not checkable

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  • The most frequent use of PNS interfaces is in FES, with clinical applications for controlling micturition and defecation by stimulating the sacral roots.

    “Nowadays, the most frequent use of PNS interfaces resides in FES, which has clinical applications in various systems designed to control micturition and defecation by stimulating the sacral roots”

    From A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems (2005) · cites this paper as Brindley et al., 1986

    The Discussion reports that most patients used sacral anterior root stimulators mainly for micturition. Methods and Results also reports that a few used S3 or S4 stimulation to aid defaecation. The paper does not establish that FES is the most frequent use of PNS interfaces overall. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • After more than 10 years of development, Brindley's group reported the first 50 cases of a radio frequency-controlled sacral anterior root stimulator implant in humans.

    “After more than 10 years of development, Brindley's group reported the first 50 cases of a radio frequency-controlled implant from series production with medical approval called sacral anterior root stimulator (SARS) in humans (Brindley et al., 1986) .”

    From A critical review of interfaces with the peripheral nervous system for the control of neuroprostheses and hybrid bionic systems (2005) · cites this paper as Brindley et al., 1986

    The Abstract reports the first 50 human recipients of sacral anterior root stimulators; Methods and Results describes external radio transmitters, and the References include development work dating to 1972. But the printed sentence goes further: Methods and Results says the first 11 implants were made in the Neurological Prostheses Unit, not series-produced, and our copy does not establish medical approval. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

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Cites

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Research works printed but not linked: 5

  1. [8]8. 8Craggs MD, Donaldson PEK, Donaldson N de N. Performance of platinum stimulating electrodes, mapped on the limit voltage plane. Med Biol Eng Comput (In press).
  2. [9]9. 9Donaldson PEK, Donaldson N de N, Brindley GS. Life of Pt and Pt-Ir stimulating electrodes in neurological pros- theses. Med Biol Eng Comput 1985;23:84-6.
  3. [15]15. Ramon y Cajal S. Degeneration and Regeneration of the Nervous System. Vol 2. London: Oxford University Press, 1928: 532-4.
  4. [17]17. 17Brindley GS. Physiology of erection and management of paraplegic fertility. In: Hargreave TB, ed. Male Infer- tility. Berlin: Springer, 1983:261-79.
  5. [19]19. Floyd K, Koley J, Morrison JFB. Afferent discharges in the sacral ventral roots of cats. J Physiol (Lond) 1975;259:37-8P.

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Related

Authors
Brindley, G. S., Polkey, C. E., Rushton, D. N., & Cardozo, L.
Affiliations
Maudsley Hospital (GB)
Venue
Journal of Neurology, Neurosurgery & Psychiatry
Publisher
BMJ
Published
1986-10-01
Volume
49
Issue
10
Pages
1104-1114
ISSN
0022-3050 (ISSN-L)
DOI
10.1136/jnnp.49.10.1104
PMC
PMC1029041
OpenAlex
W2026643567
Semantic Scholar
dbe1fc9d42d979af8398a3e04bb79f4e70b38f70
Cited by
313
References
15
Citations by year
2026: 2 · 2025: 3 · 2024: 5 · 2023: 4 · 2022: 6 · 2021: 8 · 2020: 5 · 2019: 4 · 2018: 9 · 2017: 7 · 2016: 5 · 2015: 7 · 2014: 7 · 2013: 13 · 2012: 10
FWCI
11.57
Type
journal article
Language
en
Open access
Locations
  • Journal of Neurology Neurosurgery & Psychiatry (publishedVersion)
  • PubMed Central (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Urology › Urinary Bladder and Prostate Research
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spinal Cord Injury Research
  • Health Sciences › Medicine › Rheumatology › Pelvic floor disorders treatments
Keywords
sacral anterior root stimulation, neurostimulation, paraplegia, bladder control, urinary incontinence, micturition, residual urine, voiding pressure, cerebrospinal fluid leak, root damage, long-term outcomes
MeSH terms
Adult, Autonomic Nervous System Diseases, Electrodes, Implanted, Electric Stimulation Therapy, Female, Follow-Up Studies, Humans, Erectile Dysfunction, Intraoperative Complications, Male, Middle Aged, Paraplegia, Reflex, Abnormal, Spinal Nerve Roots, Urination Disorders, Prostheses and Implants

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