# High frequency sacral root stimulation to improve bladder and bowel emptying following SCI

> **NIH VA I21** · LOUIS STOKES CLEVELAND VA MEDICAL CENTER · 2022 · —

## Abstract

Background: Spinal cord injury (SCI) leads to neurogenic bladder dysfunctions, and often includes difficulty
with emptying the bladder due to detrusor-sphincter dyssynergia (DSD). Current bladder management
strategies include catheterization, pharmaceuticals, and/or surgery, but these interventions insufficiently meet
individuals’ needs. The neurogenic bladder can be emptied using sacral anterior root stimulation (SARS) with
electrodes implanted on the sacral nerves to produce bladder contractions. However, this emptying can be
impeded by reflex contractions of the urethral sphincter. The sacral sensory roots are typically transected
(rhizotomy) to reduce these reflex contractions, but this rhizotomy also impairs desirable reflexes (e.g. sexual
function) and sacral sensation if present. Experiments in animals have shown that sacral root stimulation at
600 Hz can inhibit urethral sphincter activity, which has the potential. This approach could be used in lieu of the
rhizotomy to improve bladder emptying efficiency.
Objective: The objective of this study is to test the feasibility and potential effectiveness of 600 Hz sacral root
stimulation to limit urethral sphincter activity in individuals with neurogenic bladder dysfunction. We
hypothesize that sacral root stimulation at 600 Hz will result in lower urethral sphincter pressures compared to
pressures in response to stimulation at the lower frequencies that are typically used for SARS.
Study Design: In this feasibility study, we will enroll 8 participants, male or female, who have SCI and who
already use implanted sacral root anterior stimulation to manage their bladder. Participants will act as their own
controls. Stimulus waveforms for urethral sphincter inhibition will be tested in the clinical laboratory in a single
session. We will not need to conduct new surgeries or implant procedures. The primary outcome measure is
urethral sphincter pressure, and additional outcome measures include bladder pressure, rectal pressure, and
bladder volume as measured in clinically standard urodynamics examination.
Clinical Impact: This approach could help restore bladder function by reducing urethral sphincter activity that
impedes bladder emptying for individuals with SCI. We could improve approaches for promoting bladder
emptying by eliminating the need for sacral posterior rhizotomy.

## Key facts

- **NIH application ID:** 10485616
- **Project number:** 1I21RX004085-01
- **Recipient organization:** LOUIS STOKES CLEVELAND VA MEDICAL CENTER
- **Principal Investigator:** DENNIS BOURBEAU
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2022-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10485616

## Citation

> US National Institutes of Health, RePORTER application 10485616, High frequency sacral root stimulation to improve bladder and bowel emptying following SCI (1I21RX004085-01). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10485616. Licensed CC0.

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