Spinal cord injury (SCI) is a highly devastating injury with a variety of complications; among them are neurogenic bladder, bowel, and sexual dysfunction. We aimed to evaluate the effect of sacral anterior root stimulation with sacral deafferentation (SARS-SDAF) on neurogenic bladder and sexual dysfunction in a large well-defined spinal cord injury cohort.
In the manner of cross-sectional study, subjects undergone SARS-SDAF between September 1986 and July 2011 answered a questionnaire concerning conditions before and after surgery in the department of Neuro-Urology, Bad Wildungen, Germany.
In total 287 of 587 subjects were analyzed. Median age was 49 years (range 19-80), median time from SCI to surgery was 10 years (range 0-49), and from surgery to follow-up 13 years (range 1-25). Of the analyzed subjects, 100% of both gender used SARS for bladder emptying. On the visual analogue scale (VAS) ranging from 0 to 10 (best), satisfaction with SARS-SDAF was 10 concerning bladder emptying, however 5 and 8 regarding sexual performance, for female and male users, respectively. Baseline and follow-up comparison showed a decline in self-intermittent catheterization (p < 0.0001), partial catheterization by attendant (p = 0.0125), complete catheterization and suprapubic catheterization (p < 0.0001), transurethral catheterization (p < 0.0011), and fewer cases of involuntary urine leakage (p < 0.0001).
The SARS-SDAF is a beneficial multi-potential treatment method with simultaneous positive effect on multi-organ dysfunction among SCI subjects.
Acta neurochirurgica. 2018 May 10 [Epub ahead of print]
Hamed Zaer, Mikkel Mylius Rasmussen, Franko Zepke, Charlotte Bodin, Burkhard Domurath, Johannes Kutzenberger
Department of Neurosurgery, CENSE, Aarhus University, Nørrebrogade 44, building number 10, 5th floor, 8000, Aarhus, Denmark. hz@clin.au.dk., Department of Neurosurgery, CENSE-spine, Aarhus University Hospital, Aarhus, Denmark., Department of Neuro-Urology, Werner-Wicker-Klinik, Bad Wildungen-Reinhardhausen, Germany.