Abstract
Study design: Cross-sectional descriptive study.
Objectives: To assess long-term effects and quality of life (QoL) of using sacral anterior root stimulation (SARS) in spinal cord injured patients.
Setting: Neurosurgical and Urological Departments of a large teaching hospital and a large rehabilitation centre in the Netherlands.
Methods: In all, 42 patients with complete spinal cord injury (SCI) implanted between 1987 and 2000 were included. A questionnaire was constructed to determine complications, technical failures and personal experiences of the patients. The Qualiveen questionnaire was used and the outcome was compared with data obtained from a reference group of 400 SCI patients with neurogenic bladder problems not using the bladder controller. The Qualiveen questionnaire measures disease-specific aspects in four domains with respect to limitations, constraints, fears and feelings and general QoL aspects, suitable for use in SCI patients with urinary disorders.
Results: The results of 37 patients are presented. Our results with the bladder controller with respect to medical and technical complications and infection rates are similar to the results presented by others. From users' experiences, the most important advantages reported were a decreased infection rate (68%), improved social life (54%) and continence (54%). Comparison of the obtained results of our patient group with the Qualiveen questionnaire with a reference group not using the bladder controller indicates that the specific impact of urinary disorders in the four domains on QoL is reduced and that general QoL is improved.
Conclusion: SARS is effective and safe for neurogenic bladder management in patients with complete SCI. Users' experiences are positive. Furthermore, this therapy seems to reduce the effects of urinary-disorder-specific QoL aspects, and to increase the QoL in general.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Van Kerrebroeck PE, Koldewijn EL, Scherpenhuizen S, Debruyne FM . The morbidity due to lower urinary tract function in spinal cord injury patients. Paraplegia 1993; 31: 320–329.
Creasey GH . Electrical stimulation of sacral roots for micturition after spinal cord injury. Urol Clin North Am 1993; 20: 505–515.
Van Kerrebroeck EV et al. Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. Part I: clinical and urodynamic analysis. Dutch Study Group on Sacral Anterior Root Stimulation. Eur Urol 1997; 31: 263–271.
Brindley GS . History of the sacral anterior root stimulator, 1969–1982. Neurourol Urodyn 1993; 12: 481–483.
Brindley GS . The sacral anterior root stimulator as a means of managing the bladder in patients with spinal cord lesions. Bail Clin Neurol 1995; 4: 1–13.
Brindley GS, Rushton DN . Long-term follow-up of patients with sacral anterior root stimulator implants. Paraplegia 1990; 28: 469–475.
Brindley GS . The first 500 patients with sacral anterior root stimulator implants: general description. Paraplegia 1994; 32: 795–805.
Egon G et al. Implantation of anterior sacral root stimulators combined with posterior sacral rhizotomy in spinal injury patients. World J Urol 1998; 16: 342–349.
Van Kerrebroeck PE, Koldewijn EL, Debruyne FM . Worldwide experience with the Finetech–Brindley sacral anterior root stimulator. Neurourol Urodyn 1993; 12: 497–503.
Robinson LQ et al. Experience with the Brindley anterior sacral root stimulator. Br J Urol 1998; 62: 553–557.
Sauerwein D . Die operative Behandlung der spastischen Blasenlähmung bei Querschnittlähmung. Sakrale Deafferentation (SDAF) mil der Implantation eines sakralen Vorderwurzelstimulators (SARS). Urologe [A] 1990; 29: 196–203.
van der Aa HE, Hermes HJ, Alleman E, Vorsteveld H . Sacral anterior root stimulation for bladder control in patients with a complete lesion of the spinal cord. Acta Neurochir 1995; 134: 88–94.
Tanagho EA, Schmidt RA, Orvis BR . Neural stimulation for control of voiding dysfunction: a preliminary report in 22 patients with serious neuropathic voiding disorders. J Urol 1989; 142(2 Part 1): 340–345.
Wielink G, Essink-Bot ML, van Kerrebroeck PhEV, Rutten FFH, Dutch Study Group on Sacral Anterior Root Stimulation. Sacral rhizotomies and electrical bladder stimulation in spinal cord injury. Part II: cost-effectiveness and quality of life analysis. Eur Urol 1997; 31: 4441–4446.
Brindley GS . The first 500 sacral anterior root stimulators: implant failures and their repair. Paraplegia 1995; 33: 5–9.
Kachourbos MJ, Creasey GH . Health promotion in motion: improvement quality of life for persons with neurogenic bladder and bowel using assistive technology. SCI Nurs 2000; 17: 125–129.
Costa P et al. Quality of life in spinal cord injury patients with urinary difficulties – development and validation of Qualiveen. Eur Urol 2001; 39: 107–113.
Trudeau-Vanhems E . Manuel d'utilisation et guide d'interprétation de QUALIVEEN. Labaratoires Coloplast Fontenay-sous-Bois, France, 2000.
World Health Organization Quality of Life Group 1993b. In: Bowling A (ed). Measuring Disease. A Review of Disease-Specific Quality of Life Measurement Scales, Chapter 1, 2nd edn. Open University Press Buckingham: Philadelphia 2001, p 6.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Vastenholt, J., Snoek, G., Buschman, H. et al. A 7-year follow-up of sacral anterior root stimulation for bladder control in patients with a spinal cord injury: quality of life and users' experiences. Spinal Cord 41, 397–402 (2003). https://doi.org/10.1038/sj.sc.3101465
Published:
Issue date:
DOI: https://doi.org/10.1038/sj.sc.3101465
Keywords
This article is cited by
-
Lumbosacral spinal cord epidural stimulation improves voiding function after human spinal cord injury
Scientific Reports (2018)
-
Effect of spinal anterior root stimulation and sacral deafferentation on bladder and sexual dysfunction in spinal cord injury
Acta Neurochirurgica (2018)
-
Quality of Life and Bladder Management post Spinal Cord Injury: A Systematic Review
Applied Research in Quality of Life (2014)
