Bladder and Sphincter Control after Spinal Cord Injury

A new neuroprosthesis to restore both continence and micturition was developed in chronic spinal cord injured (SCI) cats based on pudendal nerve stimulation and blockade. The present mini-review summarizes our progress in the design and development of a new stimulation strategy to implement this new neuroprosthesis. Our studies showed that the pudendal-to-bladder spinal reflex could be either excitatory or inhibitory, depending on the frequency of pudendal nerve stimulation. High-frequency biphasic electrical stimulation can reversibly block pudendal nerve conduction to suppress detrusor sphincter dyssynergia (DSD). By combining the different frequencies of pudendal nerve stimulation, both continence and micturition could be restored in chronic SCI cats, indicating the possibility that a successful clinical application of this new stimulation strategy might be achieved in the near future.