# Kilohertz sacral root block for bladder emptying after spinal cord injury

> **NIH NIH U41** · CASE WESTERN RESERVE UNIVERSITY · 2024 · $54,905

## Abstract

ABSTRACT SUMMARY
Kilohertz sacral root block for bladder emptying after spinal cord injury
Neurogenic bladder and bowel post-SCI hugely impact quality of life and remains important unmet challenges.
Neurogenic bladder and bowel are the result of impaired control/coordination between the bladder and urethral
sphincter. In particular, detrusor-sphincter dyssynergia (DSD) results in urethral sphincter activity that obstructs
the bladder outlet during bladder emptying. Current treatment approaches, which include such things as timed
voiding strategies, catheters, pharmaceuticals, and surgical interventions, do not sufficiently address the
problem. Sacral anterior root stimulation (SARS) has been used to provide clinically effective bladd er emptying
for individuals with SCI. SARS activates the motor nerves of the bladder to evoke bladder contractions for
emptying. For individuals with DSD, reflex urethral sphincter activity can still impede bladder emptying.
Therefore, these reflex urethral contractions must be eliminated. Posterior rhizotomy, which is cutting the spinal
nerves that carry sensory signals, has been combined with SARS to abolish reflex contractions of the sphincter
and facilitate emptying. However, many individuals choose not to undergo the combination of SARS with
rhizotomy because the rhizotomy abolishes any remaining pelvic sensation and desirable reflexes, including
reflex sexual functions such as penile erection. One promising approach uses high frequency stimulation to b lock
the motor efferent neurons that drive urethral sphincter contractions. This technique has been tested via
pudendal nerve stimulation to reduce urethral sphincter pressures and promote bladder emptying. The goal of
this project is to determine the effect of sacral root stimulation frequency on contractile function of lower urinary
tract and bowel organs in order to evaluate the potential for SARS to improve bladder and bowel emptying
efficiency for individuals with spinal cord injury. In acute terminal pig experiments, we will measure continuous
bladder, urethral sphincter, rectal, and anal sphincter pressures in response to SARS at varying frequencies
from 20-10,000 Hz. We will also measure bladder emptying volumes and rates.

## Key facts

- **NIH application ID:** 10998359
- **Project number:** 3U41NS129436-02S5
- **Recipient organization:** CASE WESTERN RESERVE UNIVERSITY
- **Principal Investigator:** Cynthia Anne Chestek
- **Activity code:** U41 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $54,905
- **Award type:** 3
- **Project period:** 2024-05-01 → 2025-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10998359

## Citation

> US National Institutes of Health, RePORTER application 10998359, Kilohertz sacral root block for bladder emptying after spinal cord injury (3U41NS129436-02S5). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10998359. Licensed CC0.

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