Nerve transfer for restoration of lower motor neuron-lesioned bladder, urethral and anal sphincter function. Part 4: Effectiveness of the motor reinnervation

Abstract

The original design and necessary modifications of the project plan are as described in part 1 of this series (26). The current study is part 4 of a series reports and results from 30 animals with three main groups (Fig. 1A). The ObNT-ScNT Reinn group consisted of 8 dogs that were in the study a total of 22 months (22 ± 0.4 mo, mean ± SEM, Fig. 1B). At study onset, these ObNT-ScNT Reinn animals functionally decentralized by bilaterally transecting the dorsal roots of L7, all spinal roots caudal to L7, and the hypogastric nerves, followed by a 9-13 mo recovery period (10.4 ± 0.7 mo, Fig. 1C), then reinnervation by transfer of the obturator nerve to the vesical branch of the pelvic nerve, as well as a branch of the sciatic nerve to the pudendal nerve, that was then followed by an additional 8-12 mo recovery (11.9 ± 0.4 mo, Fig. 1C). The Decentralized group consisted of 4 animals that underwent similar decentralization followed by an 11-21 mo recovery (18 ± 2.5 mo, Fig. 1B), but no reinnervation surgeries. Controls consists of 7 sham-operated and 11 unoperated animals (18 total; Fig. 1A).