ABSTRACT
This chapter reviews some of the future possibilities for combining existing and emerging science and technologies to develop an implantable neuroprosthesis capable of restoring complete control of the bladder and sphincters in spinal cord injury. Suprasacral lesions to the spinal cord nearly always lead to serious disruption of lower urinary tract function: development of aberrant bladder and sphincter reflexes, loss of voluntary control of bladder and sphincter, and lack of sensation of bladder fullness. Sacral anterior roots contain both the large somatic nerves to the urethral striated sphincter and the small preganglionic parasympathetic nerves to the bladder detrusor smooth muscle. The chapter considers some old, new, and emerging developments and technologies using sacral root stimulation which together may, in future, provide full restoration of bladder control to the neurogenic bladder. Bladder contractions are only elicited when the bladder volume is close to maximal capacity and reported voiding efficiencies are disappointing.
