Bladder pacemaker

from Wikipedia, the free encyclopedia
This article or section needs to be revised. Details should be given on the talk page. Please help to improve it , and then remove this flag.

A bladder pacemaker (anterior root stimulation) is an electrical device in the sense of a functional electrical stimulation , which makes it possible to empty the urinary bladder in a controlled manner if necessary . A clear distinction must be made between the sacral neuromodulation (SNM - pelvic floor pacemaker ) procedure, especially because the SNM cannot be used in the case of complete paraplegia.

Problem

Controlled emptying of the bladder is a common problem in paraplegic patients.

The bladder can be emptied by rhythmically tapping ( triggering ) the bladder area and special hand movements by a trained nurse ( Crede handle ), but this usually leaves residual urine in the bladder, which can be the cause of urinary tract infections . Tapping or squeezing the bladder regularly creates high bladder pressures (see Detrusor-Sphincter Dyssynergy ), which can lead to a diverticular bladder and reflux (urine flows back into the kidneys). Many paraplegics died as a result of chronic kidney failure. In the case of damage mostly above the 6th thoracic vertebra, such as tetraplegia , autonomic dysreflexia can also lead to critical increases in blood pressure, which increase the risk of a stroke .

For many years, intermittent self-catheterization has therefore been seen as the method of choice, with the paraplegic placing a single-use catheter several times a day, even according to a certain rhythm. This measure has significantly reduced mortality.

The uncontrolled loss of urine is also a problem for this group of people if no urinary catheter has been inserted or no urinal condom is used.

Bladder pacemakers are an alternative to all of these urination maneuvers. These are implanted generators that stimulate the corresponding nerves with stimulation currents and thus lead to bladder emptying. The pacemakers are controlled by an external (non-implanted) device.

literature

  • Support Association of Paraplegics (FGQ) (Ed.): Paraplegiker 2/2010, p. 34ff.
  • Christian Hampel: Overactive bladder - Current treatment strategies for practice . 1st edition. UNI-MED, Bremen 2005, ISBN 3-89599-901-6 , pp. 63-67.

Web links