1.Application and prospect of reconstructing bladder micturition reflex in neurogenic bladder after spinal cord injury
Lifen ZHAN ; Kun AI ; Xuejiu ZENG ; Rouyun LIANG ; Qiangsheng DING ; Hong ZHANG
Chinese Journal of Tissue Engineering Research 2024;28(18):2925-2931
BACKGROUND:The dysfunction of bladder function caused by spinal cord injury is a difficult point in clinical treatment and a hot spot in research.Repairing the injured spinal cord and remodeling the bladder micturition reflex pathway are the fundamental treatment methods. OBJECTIVE:To summarize the reconstruction of the bladder innervation pathway after spinal cord transection injury and its related influencing factors. METHODS:The relevant literature concerning the reconstruction of bladder micturition reflex,neurogenic bladder and urinary reflex and spinal cord repair was retrieved on CNKI,WanFang Data,PubMed and Web of Science.Chinese and English search terms were"neurogenic bladder;spinal cord injury;micturition reflex;spinal cord repair". RESULTS AND CONCLUSION:In the process of reconstructing the bladder micturition reflex,there are many factors involved,including the repair and reconstruction of the injured spinal cord,the remodeling of micturition center,the changes of bladder tissue and substances and hormones in and out of the body.In this process,there are mainly the following problems:(1)As a complex process,there are many sites involved in the reconstruction of the micturition reflex,so the main sites of action can be selected for in-depth study,so as to break through the doubts existing in the reconstruction of the micturition reflex pathway.(2)The mechanism of the normal micturition reflex is complex.After spinal cord transection injury,whether the central nucleus mass controlling or participating in the micturition reflex is compensated and the corresponding compensatory mechanism needs to be further investigated.(3)Information communication between the center and the bladder is interrupted after spinal cord transection injury.Whether there is a direct information connection between the center and the bladder remains to be further investigated.(4)The relationship between reconstructing micturition reflex and body fluid after spinal cord transection injury needs further study.In the reconstruction of the bladder micturition reflex,the key treatment is to promote spinal cord repair,nerve reflex reconstruction,substance metabolism and bladder tissue structure adjustment through intervention.Chinese medicine and Western medicine have their methods.