M. Hohenfellner et al., REINNERVATION OF THE RAT BLADDER WITH A SOMATIC NERVE AND A STRIATED-MUSCLE FLAP, The Journal of urology, 154(6), 1995, pp. 2164-2169
Purpose: Current techniques of ventral sacral root stimulation to rega
in voluntary motor control of the decentralized urinary bladder depend
upon intact parasympathetic innervation of the detrusor. We investiga
ted techniques that might allow restoration of motor control of the bl
adder after efferent parasympathetic impairment. Materials and Methods
: In a chronic rat model, we evaluated whether motor control of a peri
pherally denervated bladder could be restored by transplantation of au
tologous excitable tissues and subsequent electrostimulation. Either a
somatic nerve or a striated muscle flap was used as the transplant. R
esults: Four months after the initial surgery, electrostimulation of t
he somatic nerve implant provoked bladder contractions-a response that
was blocked by atropine. Stimulation of the nerve innervating the str
iated muscle flap also provoked bladder contractions; these were not a
ffected by atropine and were slightly reduced by hexamethonium. Conclu
sion: Reinnervation of the bladder with somatic nerves or striated mus
cles is possible in principle. Future experiments will clarify the cli
nical significance of electrostimulation of such implants.