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Thread: Regaining control: treatment options for spinal cord injury bladder dysfunction

  1. #1

    Regaining control: treatment options for spinal cord injury bladder dysfunction

    Regaining control: treatment options for spinal cord injury bladder dysfunction
    By Leila Shobab


    The idea of introducing an electric current into your system may seem distressing. However, electrical shock is commonly used to treat patients experiencing heart conditions such as cardiac arrest. Recently, external electrical stimulation has been substituted for gym time and is used to produce "fake" stimulation of the nerves innervating muscles. This often produces the same effects that may result from an (honest) heavy-duty muscular training program. But why would someone carry a battery and some electrodes with him or even implant these devices into his body to receive these electrical stimulations?

    One major reason may be to treat the consequences of spinal cord injuries (SCI). SCI can drastically change people's lives; the psychological and socialc impact of such injuries is often devastating. Some of the general disabling conditions associated with SCI are permanent paralysis of the limbs, chronic pain, muscular atrophy, loss of voluntary control over bladder and bowel, inability to produce erection, ejaculation and infertility. The consequences of SCI depend on the specific nature of the injury and its location along the spinal cord.


    Bladder dysfunction associated with spinal cord injuries

    The loss of genitourinary function - the dysfunction of the genital and urinary organs - is one of the most important results of SCI. Specifically, neurogenic bladder, often associated with SCI, results from damage to the nerves controlling bladder function. A lesion above the sacral level (see Figure 1) of the spinal cord, which may or may not involve the brain, could affect how the bladder stores and empties urine. These upper motor lesions are most commonly seen after cerebrovascular accidents (stroke), spinal cord injuries, neurological diseases such as multiple sclerosis, and also infections.

    more....

    http://www.jyi.org/features/ft.php?id=539

  2. #2
    I think this has been existing for a while, but it has some negative sides. check these:

    http://sci.rutgers.edu/forum/showthread.php?t=6760

    http://casesjournal.com/content/2/1/9364

  3. #3
    Senior Member TomRL's Avatar
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    They have been experimenting with this a lot in Cleveland through the FES center which sprung out of work done at the Case Western Reserve School of Medicine.

    http://www.fescenter.org/index.php
    Tom

    "Blessed are the pessimists, for they hath made backups." Exasperated 20:12

  4. #4
    I would be curious what KLD and Dr. Young think about the minimally invasive technique, developed by Prof. Possover. He has treated SCI-patients with this technique since 2006:

    Laparoscopic implantation of electrodes on sacral roots, as developed by Prof. Possover, offers significant advantages in comparison with classical treatment.
    It is a minimally invasive surgical technique that does not involve any resection of vertebral fragments and requires only brief hospitalization (3 to 4 days). In addition, because the electrodes reside deep inside the pelvic cavity, the risk of wounding, shifting or infection is significantly lower.
    The following objectives can be achieved thanks to laparoscopic implantation of electrodes:
    • Electrically controlled blocking of the nerves connected to the central nervous system, leading to a decrease in intravesical pressure and an increase in bladder capacity. The sectioning of posterior nerve roots is rendered obsolete by this procedure.
    • An electrical trigger of miction, defecation, erection and ejaculation.
    • Optimal prophylaxis of bedsores and gluteal compression ulcerations. Bilateral stimulation of the sacral nerve roots stimulates the gluteal muscles, leading to significantly improved cutaneous circulation.
    • Implantation of additional electrodes
    • Implantation that does not require the removal of any vertebral element
    • Minimally invasive implantation. Hospitalization only lasts a few days instead of several weeks, as needed for the conventional method.

    http://neuropelveologie.hirslanden.c...?SelNavID=3466
    http://www.possover.de/index.php?id=19&L=1
    Last edited by wilfried; 03-28-2010 at 12:25 AM.

  5. #5
    thanks wilfried, i think i read about this long time ago in an Arabic newspaper, i tried searching that time to get more info. but didn't reach enough results.

    Do you know how the two procedures differ ?

  6. #6

    Dr Young: your opinion on Dr Possover's electrode implants

    Quote Originally Posted by wilfried View Post
    I would be curious what KLD and Dr. Young think about the minimally invasive technique, developed by Prof. Possover. He has treated SCI-patients with this technique since 2006:

    Laparoscopic implantation of electrodes on sacral roots, as developed by Prof. Possover, offers significant advantages in comparison with classical treatment.
    It is a minimally invasive surgical technique that does not involve any resection of vertebral fragments and requires only brief hospitalization (3 to 4 days). In addition, because the electrodes reside deep inside the pelvic cavity, the risk of wounding, shifting or infection is significantly lower.
    The following objectives can be achieved thanks to laparoscopic implantation of electrodes:
    • Electrically controlled blocking of the nerves connected to the central nervous system, leading to a decrease in intravesical pressure and an increase in bladder capacity. The sectioning of posterior nerve roots is rendered obsolete by this procedure.
    • An electrical trigger of miction, defecation, erection and ejaculation.
    • Optimal prophylaxis of bedsores and gluteal compression ulcerations. Bilateral stimulation of the sacral nerve roots stimulates the gluteal muscles, leading to significantly improved cutaneous circulation.
    • Implantation of additional electrodes
    • Implantation that does not require the removal of any vertebral element
    • Minimally invasive implantation. Hospitalization only lasts a few days instead of several weeks, as needed for the conventional method.

    http://neuropelveologie.hirslanden.c...?SelNavID=3466
    http://www.possover.de/index.php?id=19&L=1
    I am very interested in this procedure for my son (C6 incomplete). I have studied Dr Possover's website but there are things I don't understand. Does one push a button on a remote control device to do all the things it's meant to enable you to do? (micturate, defecate, get an erection, ejaculate) I would appreciate opinions from anyone who has had this procedure or knows someone who has. Thanks.

  7. #7
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    Still no trials from them i guess

  8. #8
    Quote Originally Posted by mamadavid View Post
    I am very interested in this procedure for my son (C6 incomplete). I have studied Dr Possover's website but there are things I don't understand. Does one push a button on a remote control device to do all the things it's meant to enable you to do? (micturate, defecate, get an erection, ejaculate) I would appreciate opinions from anyone who has had this procedure or knows someone who has. Thanks.
    Was able to answer my own question by looking at the linked website. The answer seems to be yes. Doesn't sound ideal, but I wish I could hear from someone who has had this procedure done, or from a trusted medical expert like Dr Young.

  9. #9
    I think all these different kinds of electrical stimulation being used is a good example of one of the reasons why there is no cure for spinal cord injury yet.
    The question that is being posed about Possover's stuff (and the other copy cat stuff) and whether it works, is not the right question.
    Why hasn't anyone tried to work out a definitive answer about it and then made widely available? Why are there other versions of the same thing instead of improvements made on the original and how does this impact on the total budget of scientific research.
    All the scientists running around trying to show whose is bigger and better doesn't get us to a cure or even real improvements in care.
    I have said this a hundred times and I'll say it again; I have never been worried about the science not getting to a cure, but concern is then getting US to a cure.
    There is a very good example dealing with a certain type of blindness. They have shown very high efficacy, but when I try to find out where it is being used, I hear that it's here and there. Well, why not everywhere? Here is a link to it "Such great news that it will sicken you."
    Science just to show whose is bigger is not going to get us anywhere.
    Dennis Tesolat
    www.StemCellsandAtomBombs.blogspot.com

    "Change does not roll in on the wheels of inevitability, but comes through continuous struggle. And so we must straighten our backs and work for our freedom."
    Martin Luther King

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