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Surgeons from Manipal hospital treats neurogenic bladder dysfunction
Our Bureau, Bangalore | Saturday, June 12, 2004, 08:00 Hrs  [IST]

Neurosurgeons at Manipal Hospital's Institute of Neurological Disorder (MIND) blazed a trail as they treated a patient with Neurogenic Bladder Dysfunction by performing the 'Sacral Nerve Stimulation' for the first time in South India.

The team, led by Dr. N K Venkataramana, director, MIND, performed the procedure on 17-year old boy from Tamil Nadu.

Neurogenic bladder occurs among patients affected with neurological diseases affecting the brain and spinal cord and Sacral nerves.

Since the patient Sukumar's MRI scan did not reveal any structural abnormality of the spinal cord, he was given trial stimulation by placing an electrode over S3 nerve root percutaneously. The stimulation has improved his bladder function significantly. Hence a permanent implantation of the electrode and stimulation device was done. After the implantation, he is able to pass urine without the need of catheterization. His social behaviour has improved, such as ability to mix with friends and now wants to study in a boarding school, explained Dr. Venkatramana.

Dr. Venkatramana informed, that the two primary functions of lower urinary tract are performed by a synchronized action of urinary bladder and urethra with its sphincters. These two functions are controlled by neural circuits located mainly in the brain and Lumbosacral spinal cord. Any dysfunction due to disturbance in these neurological circuits is termed as Neurogenic Bladder Dysfunction.

Sacral nerve stimulation is considered to be a viable alternative for select patients to induce normal voiding of urine. Also called 'Interstim Therapy,' the procedure is performed using a battery-powered pulse generator connected to quadripolar electrode through a cable. The voltage parameters are adjustable by periodic programming. It induces constant electrical stimulation helping them to urinate normally.

Last year MIND, one of the largest neurological service providing units in India, had performed the first Intrathecal baclofen pump implantation for chronic spasticity patients, Programmable shunt implantation and a Computer Assisted Cognitive Retraining programme for neuro rehabilitation.

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