A new technique for the rehabilitation of urinary and fecal functions in paraplegic patients

  For urinary and fecal incontinence in paraplegic patients, long-term retention of catheters, suprapubic cystostomy or clean catheterization are mostly used, which can easily lead to recurrent urinary tract infections and later renal function damage; the reduced bladder capacity and urinary storage function after paraplegia make patients have to urinate 2-4 times at night and cannot get a complete sleep. At the same time, the general odor brought by urinary incontinence makes patients reluctant to go out and integrate into society, causing harm to both physical and psychological health of patients.  In recent years, the sacral anterior root stimulation (SARS) technique, which has been gradually applied in western developed countries, has partially solved this problem of urinary and fecal incontinence after paraplegia. The core part of this technology is a set of electrical stimulator invented by British scientist Brindley, namely Finetech-Brindley bladder control system, including two parts: in vivo and in vitro (see Figure 1), the in vivo part consists of electrodes ringed on the anterior sacral nerve root, connecting wires and an electromagnetic wave receiving coil placed under the skin of the abdomen, and the in vitro part is an electromagnetic wave reflector; working When the external electromagnetic wave transmitter is placed close to the coil under the skin of the abdomen, the electromagnetic wave is converted into electric current and conducted to the sacral nerve root, which generates nerve potential and conducts along the nerve to the bladder, causing the bladder to contract and discharge urine.  Due to the excellent efficacy and long-term stable performance of this new product, it has become the most valuable method for clinical application and has been carried out in nearly 3000 cases worldwide. The reason for the late start in this area in China is that, on the one hand, this technology is a marginal discipline between orthopedics (spinal surgery) – urology – neurosurgery, and has not attracted sufficient attention; on the other hand, the expensive price of the product in the early days also limited the use of the country, but recently the price of the product has been reduced to less than 10,000 dollars, and some patients can still afford it. Some patients can still afford it. Since the use of this technology reduces the chance of urinary tract infections, medical economics survey results show that the cost of using the product for more than 7 years will be lower than the cost of treating urinary tract infections, etc., and the vast majority of patients use the product for much longer than 7 years.