Ann Rehabil Med.  2012 Apr;36(2):213-219. 10.5535/arm.2012.36.2.213.

Radiofrequency Sacral Rhizotomy for the Management of Intolerable Neurogenic Bladder in Spinal Cord Injured Patients

• Cho KH
• Lee SS

• KMID: 2266759
• DOI: http://doi.org/10.5535/arm.2012.36.2.213

Abstract

OBJECTIVE
To investigate the effect of radiofrequency (RF) sacral rhizotomy of the intolerable neurogenic bladder in spinal cord injured patients. METHOD: Percutaneous RF sacral rhizotomy was performed on 12 spinal cord injured patients who had neurogenic bladder manifested with urinary incontinence resisted to an oral and intravesical anticholinergic instillation treatment. Various combinations of S2, S3, and S4 RF rhizotomies were performed. The urodynamic study (UDS) was performed 1 week before RF rhizotomy. The voiding cystourethrogram (VCUG) and voiding diaries were compared 1 week before and 4 weeks after therapy. Total volume of daily urinary incontinence (ml/day) and clean intermittent catheterization (ml/time) volume of each time were also monitored.
RESULTS
After RF sacral rhizotomy, bladder capacity increased in 9 patients and the amount of daily urinary incontinence decreased in 11 patients. The mean maximal bladder capacity increased from 292.5 to 383.3 ml (p<0.05) and mean daily incontinent volume decreased from 255 to 65 ml (p<0.05). Bladder trabeculation and vesicoureteral reflux findings did not change 4 weeks after therapy.
CONCLUSION
This study revealed that RF sacral rhizotomy was an effective method for neurogenic bladder with uncontrolled incontinence using conventional therapy among spinal cord injured patients.

Keyword

Spinal cord injury; Neurogenic bladder; Hyperactive detrusor muscle; Radiofrequency; Sacral rhizotomy

MeSH Terms

Humans
Intermittent Urethral Catheterization
Rhizotomy
Spinal Cord
Spinal Cord Injuries
Urinary Bladder
Urinary Bladder, Neurogenic
Urinary Incontinence
Urodynamics
Vesico-Ureteral Reflux

Figure

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  Fig. 1 Selective nerve root infiltration of S2 root. Left anteroposterior roenterogram shows the proper placement of the spinal needles at S2 sacral foramen for radiofrequency sacral rhizotomy. Right side shows the outline of S2 nerve root by the contrast material.

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