Experience with the Brindley anterior sacral root stimulator.

Brindley anterior sacral root stimulators have been implanted into 22 spinal cord injured patients from the spinal injury units in Cardiff and Sheffield. The group comprised 20 men and 2 women (15 paraplegics and 7 tetraplegics); 16 patients are using the implant, of whom 11 (68%) are continent. Of the remaining 5, 4, who empty completely, are incontinent because of inability to use the implant with sufficient frequency; 6 patients are not using their implant, though 4 are continent. Of 11 patients with detrusor/sphincter dyssynergia, sphincterotomy was necessary in 3 patients before implantation and in a further 3 after implantation. Of 4 patients with abnormal upper tracts prior to implantation, 2 resolved and 2 deteriorated, in the presence of dyssynergia; 1 patient developed hydronephrosis after implantation, having previously had normal upper tracts. Although erectile function with the stimulator was clinically adequate in 6 patients, in no patient has intercourse been achieved because of concurrent lower limb spasm.