Introduction: Neurogenic bladder dysfunction after spinal cord injury (SCI) is a major medical and social problem. In this study we assessed the effectiveness of neurogenic bladder reinnervation in patients with SCI using a normal S1 nerve root. Methods: Nine patients with bladder dysfunction caused by injury to the low conus medullaris (S2–S5) underwent a novel surgical procedure in which the unilateral proximal end of the S1 ventral root (VR) was anastomosed to the distal end of the S2 and S3 VRs. Results: Seven patients regained satisfactory bladder control within 8–12 months after VR microanastomosis. The average residual urine volume decreased from 186.0 ± 35.0 ml to 43.0 ± 10.0 ml, and no urinary infections occurred. Conclusions: These results suggest the effectiveness of bladder innervation by S1 nerve transfer, which could provide a new approach for the reconstruction of atonic bladder function caused by low conus medullaris injuries. Muscle Nerve, 2013
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