{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:50:49Z","timestamp":1765828249646,"version":"3.30.1"},"reference-count":14,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Bladder dysfunction after nerve injury has a variable presentation, and extent of injury determines whether the bladder is spastic or atonic. The authors have proposed a series of 3 nerve transfers for functional innervation of the detrusor muscle and external urethral sphincter, along with sensory innervation to the genital dermatome. These transfers are applicable to only cases with low spinal segment injuries (sacral nerve root function is lost) and largely preserved lumbar function. Transfer of the posterior branch of the obturator nerve to the vesical branch of the pelvic nerve provides a feasible mechanism for patients to initiate detrusor contraction by thigh adduction. External urethra innervation (motor and sensory) may be accomplished by transfer of the vastus medialis nerve to the pudendal nerve. The sensory component of the pudendal nerve to the genitalia may be further enhanced by transfer of the saphenous nerve (sensory) to the pudendal nerve. The main limitations of coapting the nerve donors to their intrapelvic targets are the bifurcation or arborization points of the parent nerve. To ensure that the donor nerves had sufficient length and diameter, the authors sought to measure these parameters.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Twenty-six pelvic and anterior thigh regions were dissected in 13 female cadavers. After the graft and donor sites were clearly exposed and the branches identified, the donor nerves were cut at suitable distal sites and then moved into the pelvis for tensionless anastomosis. Diameters were measured with calipers.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The obturator nerve was bifurcated a mean \u00b1 SD (range) of 5.5 \u00b1 1.7 (2.0\u20139.0) cm proximal to the entrance of the obturator foramen. In every cadaver, the authors were able to bring the posterior division of the obturator nerve to the vesical branch of the pelvic nerve (located internal to the ischial spine) in a tensionless manner with an excess obturator nerve length of 2.0 \u00b1 1.2 (0.0\u20135.0) cm. The distance between the femoral nerve arborization and the anterior superior iliac spine was 9.3 \u00b1 1.8 (6.5\u201315.0) cm, and the distance from the femoral arborization to the ischial spine was 12.9 \u00b1 1.4 (10.0\u201316.0) cm. Diameters were similar between donor and recipient nerves.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>The chosen donor nerves were long enough and of sufficient caliber for the proposed nerve transfers and tensionless anastomosis.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2022.8.spine22291","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T08:49:54Z","timestamp":1665737394000},"page":"258-264","source":"Crossref","is-referenced-by-count":4,"title":["Restoring bladder function using motor and sensory nerve transfers: a cadaveric feasibility study"],"prefix":"10.3171","volume":"38","author":[{"given":"Benjamin R.","family":"Johnston","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Boston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stanley","family":"Bazarek","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women\u2019s Hospital, Boston;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret","family":"Sten","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian S.","family":"McIntyre","sequence":"additional","affiliation":[{"name":"Drexel University College of Medicine, Philadelphia, Pennsylvania;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Noam","family":"Fine","sequence":"additional","affiliation":[{"name":"Department of Urology, Massachusetts General Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elise J. B.","family":"De","sequence":"additional","affiliation":[{"name":"Department of Urology, Massachusetts General Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis","family":"McGovern","sequence":"additional","affiliation":[{"name":"Department of Urology, Massachusetts General Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nucelio","family":"Lemos","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynaecology, University of Toronto, Ontario, Canada; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael R.","family":"Ruggieri","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary F.","family":"Barbe","sequence":"additional","affiliation":[{"name":"Department of Anatomy and Cell Biology, Lewis Katz School of Medicine, Philadelphia, Pennsylvania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin M.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Massachusetts General Hospital, Boston, Massachusetts;"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"1","key":"b1","series-title":"Compr Physiol","first-page":"327","article-title":"Neural control of the lower urinary tract","volume":"5","author":"de Groat WC","year":"2015","unstructured":"de Groat WC, Griffiths D, Yoshimura N. Neural control of the lower urinary tract. Compr Physiol. 2015;5(1):327\u2013396.25589273"},{"issue":"2","key":"b2","series-title":"Int J Urol","first-page":"111","article-title":"Neural control of the lower urinary tract","volume":"4","author":"Yoshimura N","year":"1997","unstructured":"Yoshimura N, de Groat WC. Neural control of the lower urinary tract. Int J Urol. 1997;4(2):111\u2013125.9179682"},{"issue":"5","key":"b3","series-title":"Pediatr Nephrol","first-page":"717","article-title":"The neurogenic bladder: medical treatment","volume":"23","author":"Verpoorten C","year":"2008","unstructured":"Verpoorten C, Buyse GM. The neurogenic bladder: medical treatment. Pediatr Nephrol. 2008;23(5):717\u2013725.18095004"},{"key":"b4","first-page":"816274","article-title":"Neurogenic bladder","volume":"2012","author":"Dorsher PT","year":"2012","unstructured":"Dorsher PT, McIntosh PM. Neurogenic bladder. Adv Urol.2012;2012:816274.22400020"},{"issue":"2","key":"b5","series-title":"Indian J Urol","first-page":"245","article-title":"Managing the urinary tract in spinal cord injury","volume":"26","author":"Harrison SCW","year":"2010","unstructured":"Harrison SCW. Managing the urinary tract in spinal cord injury. Indian J Urol. 2010;26(2):245\u2013252.20877604"},{"issue":"8","key":"b6","series-title":"J Neurotrauma","first-page":"1548","article-title":"The health and life priorities of individuals with spinal cord injury: a systematic review","volume":"29","author":"Simpson LA","year":"2012","unstructured":"Simpson LA, Eng JJ, Hsieh JTC, Wolfe DL. The health and life priorities of individuals with spinal cord injury: a systematic review. J Neurotrauma. 2012;29(8):1548\u20131555.22320160"},{"issue":"6","key":"b7","series-title":"Am J Physiol Regul Integr Comp Physiol","first-page":"R897","article-title":"Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 2: Correlation between histological changes and nerve evoked contractions","volume":"320","author":"Barbe MF","year":"2021","unstructured":"Barbe MF, Testa CL, Cruz GE,  Nerve transfer for restoration of lower motor neuron-lesioned bladder function. Part 2: Correlation between histological changes and nerve evoked contractions. Am J Physiol Regul Integr Comp Physiol. 2021;320(6):R897\u2013R915.33759573"},{"issue":"4","key":"b8","series-title":"J Neurotrauma","first-page":"401","article-title":"Functional reinnervation of the canine bladder after spinal root transection and genitofemoral nerve transfer at one and three months after denervation","volume":"25","author":"Ruggieri MR","year":"2008","unstructured":"Ruggieri MR, Braverman AS, D\u2019Andrea L, Betz R, Barbe MF. Functional reinnervation of the canine bladder after spinal root transection and genitofemoral nerve transfer at one and three months after denervation. J Neurotrauma. 2008;25(4):401\u2013409.18373487"},{"issue":"3","key":"b9","series-title":"J Urol","first-page":"1042","article-title":"Bladder reinnervation using a primarily motor donor nerve (femoral nerve branches) is functionally superior to using a primarily sensory donor nerve (genitofemoral nerve)","volume":"193","author":"Gomez-Amaya SM","year":"2015","unstructured":"Gomez-Amaya SM, Barbe MF, Brown JM,  Bladder reinnervation using a primarily motor donor nerve (femoral nerve branches) is functionally superior to using a primarily sensory donor nerve (genitofemoral nerve). J Urol. 2015;193(3):1042\u20131051.25066874"},{"issue":"1","key":"b10","series-title":"Neurourol Urodyn","first-page":"181","article-title":"Bladder reinnervation by somatic nerve transfer to pelvic nerve vesical branches does not reinnervate the urethra","volume":"39","author":"Barbe MF","year":"2020","unstructured":"Barbe MF, Braverman AS, Salvadeo DM,  Bladder reinnervation by somatic nerve transfer to pelvic nerve vesical branches does not reinnervate the urethra. Neurourol Urodyn. 2020;39(1):181\u2013189."},{"key":"b11","series-title":"StatPearls [Internet]","article-title":"Anatomy, Abdomen and Pelvis, Obturator Nerve","author":"Koh M","year":"2022","unstructured":"Koh M, Markovich B. Anatomy, Abdomen and Pelvis, Obturator Nerve. In: StatPearls [Internet]. StatPearls Publishing;2022."},{"issue":"2","key":"b12","series-title":"J Neurosurg Spine","first-page":"258","article-title":"Nerve transfer for restoration of lower motor neuron-lesioned bladder and urethra function: establishment of a canine model and interim pilot study results","volume":"32","author":"Tiwari E","year":"2019","unstructured":"Tiwari E, Salvadeo DM, Braverman AS,  Nerve transfer for restoration of lower motor neuron-lesioned bladder and urethra function: establishment of a canine model and interim pilot study results. J Neurosurg Spine. 2019;32(2):258\u2013268.31703192"},{"issue":"5","key":"b13","series-title":"Clin Anat","first-page":"778","article-title":"The adductor part of the adductor magnus is innervated by both obturator and sciatic nerves","volume":"27","author":"Takizawa M","year":"2014","unstructured":"Takizawa M, Suzuki D, Ito H, Fujimiya M, Uchiyama E. The adductor part of the adductor magnus is innervated by both obturator and sciatic nerves. 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Neurourol Urodyn. 2011;30(8):1695\u20131704.21953679"}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/38\/2\/article-p258.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/38\/2\/article-p258.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/38\/2\/article-p258.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:10:55Z","timestamp":1733490655000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/38\/2\/article-p258.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,1]]},"references-count":14,"journal-issue":{"issue":"2"},"URL":"https:\/\/doi.org\/10.3171\/2022.8.spine22291","relation":{},"ISSN":["1547-5654"],"issn-type":[{"type":"print","value":"1547-5654"}],"subject":[],"published":{"date-parts":[[2023,2,1]]}}}