Differential sacral rhizotomy in the treatment of neurogenic bladder dysfunction

Abstract

✓ This report describes a technique of differential sacral rhizotomy for the treatment of neurogenic bladder dysfunction, particularly symptoms of frequency, urgency, and incontinence due to detrusor hyperreflexia. Under cystometric control, the sacral nerve roots are stimulated and anesthetized to determine the correct roots for section. Under magnification, cutting a few but not all of the fascicles in one or two roots increases bladder capacity while preserving detrusor reflex and sphincter function. Air cystometry and selective percutaneous sacral nerve blocks are used preoperatively to determine whether the operative procedure could be of value in relieving the symptoms. Our experience with six patients so evaluated and treated has been encouraging.