Studies on the Sacral Reflex Arc in Paraplegia

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Abstract
The human bladder is innervated through the 2d, 3d and 4th sacral nerves. Transection of the spinal cord results in dysfunction of the reflex through these nerves with resulting urinary retention. Since the sympathetic nervous system does not influence bladder function, the bladder may be relieved of nervous control by elimination of the sacral reflex arc. Bladder function was studied in 5 paraplegic patients with anterior and posterior rhizotomy from T12-S5 and in 3 paraplegic patients with anterior rhizotomy from T12-S5. Bladder automaticity developed in 6 out of the 8 cases, suggesting that the bladder possesses a functional mechanism of its own exclusive of the central nervous system. Although the nature of this auto-mechanism remains obscure, the knowledge of its existence and its surgical production is of clinical importance.

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