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Ferenc A. Jolesz, MD; Paul W. Ruenzel; Elwood Henneman, MD

Arch Neurol. 1988;45(1):38-40.

Abstract
• When the spinal motoneurons innervating the external sphincter of the urethra cannot be inhibited voluntarily due to lesions of the spinal cord, the normal capacity to relax this physiologic valve during micturition is lost. Even if contractions of the bladder occur, urinary outflow may be completely blocked at the sphincter, leading to distention of the bladder and the risk of urinary infection. A method is described for controllably relaxing the sphincter, which permits free outflow of urine in paraplegic cats. One pudendal nerve is sectioned, paralyzing half of the sphincter, but leaving the experimental animals entirely continent. The motoneurons supplying the other half of the sphincter are inhibited by means of spinal reflexes, eliminating active resistance to urethral flow. The simplicity of this approach suggests that it may prove equally effective in human paraplegia.

Author Affiliations
From the Departments of Radiology (Dr Jolesz) and Physiology and Biophysics (Dr Henneman and Mr Ruenzel), Harvard Medical School, and the Department of Radiology, Brigham and Women's Hospital (Dr Jolesz), Boston.

Footnotes
Accepted for publication Sept 10, 1987.

Presented, in part, at the 15th annual meeting of the Society for Neuroscience, Dallas, Oct 24, 1985, and at the Wakeman Award ceremonies, Duke Medical Center, Durham, NC, Nov 16, 1986.

Reprint requests to Department of Radiology, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Dr Jolesz).

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