Detrusor myoplasty and neuromuscular electrical stimulation of the urinary bladder

摘要

A system and method for inducing micturition in patients with areflexic bladders or an otherwise diminished capacity to intentionally micturate are disclosed. The method disclosed comprises the steps of transecting a patient's rectus abdominis muscle between the xiphoid and umbilicus, preserving the patient's inferior epigastric artery and 2 to 4 innervating intercostal nerves and thereby creating a muscle flap attached to the symphysis pubis; wrapping the muscle flap around the patient's bladder and suturing it to itself to create a muscle bag around the bladder; attaching to the muscle bag and/or at least one of the innervating intercostal nerves, at least one electrical lead which is attached to an actuatable signal generator that comprises one or more switches and a power source; and actuating the switch of the actuatable signal generator in order to deliver a series of stimulus pulses from the signal generator to the muscle bag which are sufficient to cause the muscle bag to contract.