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Nat Rev Urol. 2015 Feb;12(2):100-18. doi: 10.1038/nrurol.2015.4.

Neural reconstruction methods of restoring bladder function.

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Department of Anatomy and Cell Biology, Temple University School of Medicine, 3500 North Broad Street, Philadelphia, PA 19140, USA.
Department of Pharmacology and Chemical Biology, University of Pittsburgh, W1352 Thomas E. Starzl Biomedical Science Tower, Pittsburgh, PA 15261, USA.
Division of Neurosurgery, University of California San Diego School of Medicine, 200 West Arbor Drive, San Diego, CA 92103-8893, USA.
Pediatric Neuroscience Centre, All Children's Hospital, 601 5th Street South, Department 7855, Suite 511, St Petersburg, FL 33701, USA.
Department of Surgery, Division of Urology, McGill University, 3755 Cote Ste-Catherine, Montreal, QC H3T 1E2, Canada.
Department of Art, Barton College, 700 Vance Street NE, Wilson, NC 27893, USA.


During the past century, diverse studies have focused on the development of surgical strategies to restore function of a decentralized bladder after spinal cord or spinal root injury via repair of the original roots or by transferring new axonal sources. The techniques included end-to-end sacral root repairs, transfer of roots from other spinal segments to sacral roots, transfer of intercostal nerves to sacral roots, transfer of various somatic nerves to the pelvic or pudendal nerve, direct reinnervation of the detrusor muscle, or creation of an artificial reflex pathway between the skin and the bladder via the central nervous system. All of these surgical techniques have demonstrated specific strengths and limitations. The findings made to date already indicate appropriate patient populations for each procedure, but a comprehensive assessment of the effectiveness of each technique to restore urinary function after bladder decentralization is required to guide future research and potential clinical application.

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