Regaining control: treatment options for spinal cord injury bladder dysfunction
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.
Until recently, the main consequences of spinal cord injury were confinement to a wheelchair and a lifetime of medical help. Treatment options for SCI used to be limited; the available care was highly unsatisfactory and frustrating due to its limited success, unwanted side effects and high costs. However, this has changed since recent advances in neuroscience have drawn considerable attention to research into SCI and have made significantly better treatment and rehabilitation options available.