# Nerve transfer for urinary bladder reinnervation: Organ donor and cadaver studies

> **NIH NIH R21** · TEMPLE UNIV OF THE COMMONWEALTH · 2021 · $435,875

## Abstract

Aim 1: establish that functional electrical stimulation (FES) of specific anterior vesical branches of the pelvic
nerve leading to the urinary bladder causes increased urinary bladder pressure in beating heart, brain dead
human organ donors. Aim 2: develop a robotic-assisted laparoscopic approach for bladder reinnervation by
nerve transfer of obturator nerve branches to anterior vesical branches of the pelvic nerve. This will form the
foundation for a future clinical trial of nerve transfer surgery for restoration of bladder emptying function.
Our ongoing preclinical canine studies over the past 18 years seek to develop surgical approaches to
reinnervate the lower motor neuron-lesioned urinary bladder, urethra and anal sphincter. We had remarkable
success and now plan to begin clinical translation. We clearly documented functional reinnervation of the
bladder, assessed by induction of bladder contraction with electrical stimulation of transferred nerves when the
reinnervation surgery is performed immediately after the decentralization,21 at one and three months20 and now
at one year after decentralization.29 Because of this preclinical success, we propose clinical translation to human
patients that have lost control of bladder emptying function. We have clearly demonstrated in cadavers that nerve transfer
to the vesical branches of the pelvic nerve innervating to the urinary bladder is technically feasible using a variety of donor
nerves.2,6,7 However, prior to drawing the conclusion that these methods will lead to functional detrusor reinnervation, we
need to confirm that the anatomical configuration of these particular vesical branches of the pelvic nerve in
humans is sufficiently similar to the animal model such that stimulation will result in effective detrusor
contraction. This would provide the final evidence that the nerve transfer surgeries will be successful in human
subjects. In contrast to the open laparoscopic approaches used in the animal model, establishing a robotic-assisted
laparoscopic approach to obturator to pelvic nerve transfer for bladder reinnervation in non-embalmed cadavers will
provide surgeons with expertise in the surgical procedures prior to a clinical trial and is expected, in comparison with the
open procedure, to greatly reduce the recovery time and improve clinical outcomes.
Long term impact: Successful confirmation in human cadavers and in beating heart organ donors will provide
confidence that nerve transfer to these vesical branches of the pelvic nerve will reinnervate the detrusor and
restore bladder emptying function to patients that have lost control of their bladder. There is no universally
effective therapy for loss of detrusor activity, thus there is an urgent need to identify an effective treatment
for this condition. The study described in this proposal will provide the final proof for the feasibility of
reinnervation of the human urinary bladder for restoration of bladder emptying function and facilita...

## Key facts

- **NIH application ID:** 10286172
- **Project number:** 1R21NS123206-01
- **Recipient organization:** TEMPLE UNIV OF THE COMMONWEALTH
- **Principal Investigator:** Mary F Barbe
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $435,875
- **Award type:** 1
- **Project period:** 2021-08-01 → 2024-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10286172

## Citation

> US National Institutes of Health, RePORTER application 10286172, Nerve transfer for urinary bladder reinnervation: Organ donor and cadaver studies (1R21NS123206-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10286172. Licensed CC0.

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