Electric stimulation of the paraplegic bladder.

D ESPITE SIGNIFICANT improvements within the last 20 years, in both patient care and antibiotic therapy , the major cause of death among victims of paraplegia is still urologic disease. In addition to this everpresent threat, many paraplegics live with chronic high urine residuals and concomitant urinary infections and suffer, as well, the embarrassment caused by lack of voluntary control of micturition. The estimated 150,000 paraplegics in the United States, therefore, challenge the physician to consider more ingenious methods than those of enhanced drug regimens and improved patient management as the sole means of prolonging life. Spurred on by the miniaturization of electronic circuitry, investigators have begun a series of investigations into the feasibility of using electric stimulation for the treatment of neurogenic bladders. consists of a series of studies, experimental and clinical, using an im-plantable radio-linked bladder stimulator. Developed in collaboration with the Avco-Everett Research Laboratories of Everett, Massachusetts, the stimu-lator consists of an electronic unit in two separate parts. The transmitter portion, shaped like a boy-scout flashlight, is powered by four 9 volt batteries that transmit voltage A pioneer in the now burqeoning field o f bioelectronic assistance devices for the disabled, he has developed, a m o n g others, the cardiac pacemaker, a prosthetic l e f t ventricle or " booster heart, " and the bladder stimulator described above. Enoisioned. experimented u , i t h. but not yet f u l l y dvcvloped. is an electronic deoice t o a.ssist coordinated l i m b m o v e m e n t i n p a r a-plegics. KANTROWITZ HALD Hospital. He is a graduate o f the University of Copenhagen, where he began his w o r k on the electrical stimulation of neurogenic bladders. at 100 kilocycles per second with a 20 cycle modulation. This compact unit with its simple push button can be operated easily by any dextrous patient. The receiving unit is implanted in a subcutaneous pocket created in the patient's abdomen during a relatively simple operative procedure under general anesthesia. The disc-shaped receiver is approximately b5 " thick and 1 % " in diameter. Coated with silicone rubber, it is well tolerated by the body and the implantation procedure eliminates the need for transcutaneous wire connectors which, in addition to enhancing its flexibility, reduces the risk of infection. Two or four silastic-insulated leads extend from the receiver …