MP68-20 LUMBAR TO SACRAL ROOT REROUTING TO RESTORE VOIDING FUNCTION IN A FELINE SPINAL CORD INJURY MODEL: URODYNAMIC AND RETROGRADE NERVE TRACING RESULTS FROM A PILOT STUDY

Abstract

You have accessJournal of UrologyUrodynamics/Lower Urinary Tract Dysfunction/Female Pelvic Medicine: Basic Research & Pathophysiology II1 Apr 2016MP68-20 LUMBAR TO SACRAL ROOT REROUTING TO RESTORE VOIDING FUNCTION IN A FELINE SPINAL CORD INJURY MODEL: URODYNAMIC AND RETROGRADE NERVE TRACING RESULTS FROM A PILOT STUDY Ornella Lam van ba, Mary F. Barbe, Romain Caremel, Shachar Aharony, Oleg Loutochin, Line Jacques, Matthew Woods, Gerald F. Tuite, Michael R. Ruggieri, Lysanne Campeau, and Jacques Corcos Ornella Lam van baOrnella Lam van ba More articles by this author , Mary F. BarbeMary F. Barbe More articles by this author , Romain CaremelRomain Caremel More articles by this author , Shachar AharonyShachar Aharony More articles by this author , Oleg LoutochinOleg Loutochin More articles by this author , Line JacquesLine Jacques More articles by this author , Matthew WoodsMatthew Woods More articles by this author , Gerald F. TuiteGerald F. Tuite More articles by this author , Michael R. RuggieriMichael R. Ruggieri More articles by this author , Lysanne CampeauLysanne Campeau More articles by this author , and Jacques CorcosJacques Corcos More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.1357AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Following complete spinal cord injury (SCI), lumbar to sacral rerouting surgery has the potential to allow voiding via a new skin-central nervous system-bladder reflex pathway. We aimed to assess whether this surgery is effective in treating neurogenic bladder in a feline SCI model METHODS Eight cats underwent SCT at T9-T10. Unilateral L7-S1 ventral root anastomosis was performed 1 month later in 6 cats. Remaining dorsal and ventral roots below L7 were transected, bilaterally. Bladders were checked three times per day and emptied with the Crede maneuver. The new neurological pathway was evaluated at 3, 5, 7 and 9 months by electrical and manual cutaneous stimulation of L7 dermatomes and urodynamics. At 9 months, cats were euthanized 2 weeks after bladder wall Fluorogold retrograde tracer injection and an assessor-blinded pathological exam of the L7-S1 root anastomosis site and lumbosacral cord ventral horns for presence of Fluorogold labeled cell bodies was performed. Outcomes included: 1) urodynamic responses to cutaneous or electrical stimulation the L7 dermatome 2) axonal growth from L7 and S1 ventral horns to the bladder; and 3) incidence of bladder hypertrophy RESULTS At 9 months, 3 of the 6 rerouted cats exhibited increased detrusor pressure provoked by unilateral cutaneous stimulation, and one cat bilaterally. Ipsilateral cutaneous stimulation produced a voiding stream in 2 cats. SCI controls did not respond. Mean bladder volume or weight was not different between rerouted animals and SCI controls. Postmortem studies determined the anastomosed ventral roots were one-sided L7 to S1 (3 right-sided rerouting and 3 left-sided). One right-rerouted cat also showed the left L7 ventral root was annealed to the right S1 root. Although some aberrant axonal regrowth was observed, all 6 rerouted animals showed regrowth of axons from the L7 ventral horn segment to the bladder using retrograde tracing, (Figure 1) including the animal with bilateral input to S1 CONCLUSIONS L7-to-S1 ventral root rerouting surgery below the level of SCT showed successful axonal regrowth to the bladder in all rerouted animals and induced urodynamic responses to cutaneous stimulation in a subset. This feasibility study paves the way for future studies for bladder re-innervation © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e897 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Ornella Lam van ba More articles by this author Mary F. Barbe More articles by this author Romain Caremel More articles by this author Shachar Aharony More articles by this author Oleg Loutochin More articles by this author Line Jacques More articles by this author Matthew Woods More articles by this author Gerald F. Tuite More articles by this author Michael R. Ruggieri More articles by this author Lysanne Campeau More articles by this author Jacques Corcos More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...