(转自: http://www.denverpost.com/search/ci_4864628)
Surgery may aid urination in some
By Lauran Neergaard
The Associated Press
Article Last Updated: 12/19/2006 02:57:24 AM MST
Washington - Needing a wheelchair isn't always the biggest complaint of people left paralyzed by spinal-cord injury - it's also the loss of bladder control. On Monday, Michigan doctors began a unique experiment to see if rerouting patients' nerves might fix that.
It's a delicate operation: Surgeons cut open a spot on the spine and sew two normally unrelated nerves together - one from the bladder to one from the thigh - with a single hair-thin stitch. It will take months for this new nerve bridge to heal, an anxious waiting period for the first volunteers.
But if it works, merely scratching the thigh should signal the bladder to empty, allowing patients to ditch their despised catheters and restore a degree of freedom, as well as reducing bladder infections and other serious complications.
"I've got nothing to lose by doing this" is the way Kevin Bryant, 19 and paralyzed from the waist down by a car crash, approaches the experiment.
It's a technique pioneered in China. Surgeons at Wil liam Beaumont Hospital in Royal Oak, Mich., hope their U.S. study will show whether the approach is a solution for some patients.
Monday's first volunteer: a 49-year-old paralyzed from a car crash, Kevin Conkey of Fenton, Mich. On Thursday, Bryant undergoes the procedure - in addition to a child with spina bifida, an improperly formed spinal cord that can cause similar bladder dysfunction.
After infancy, the brain takes over control of urination. The bladder sends "I'm full" signals up the spinal cord. Once the person is in an appropriate spot, the brain signals back to the bladder to empty.
In spinal-cord injury and spina bifida, that control is disrupted, leaving patients either unable to urinate or constantly wet. They depend on catheters to empty the bladder every few hours.
Recurrent infections and even life-threatening kidney damage from backed-up bladders are common, not to mention the inconvenience and embarrassment the procedure brings.
(转自: http://www.denverpost.com/search/ci_4864628)