Aim was to investigate the effects of spinal cord epidural stimulation (scES) to improve bladder storage and emptying, 8 individuals (32.1 ± 4.6 years of age; 7 males, 1 female) with motor complete spinal cord injury
(SCI) (average time since injury at 9.1 ± 2.5 years at C3-T2 spinal cord level) 7 previously implanted with a 16-electrode array (5–6–5 Specify, Medtronic, Minneapolis, MN, USA.) at the T11–L1 vertebral levels over spinal cord segments L1–S1 ant the newly implanted patient at L2-S2 (Initial time frame of enrollment in this study following implant surgery of 3.3 ± 2.8 years) and one implated for this protocol (24 days before the initial training), and connected to the pulse generator (Restore ADVANCED (B21, B23), or Intellis (A101, A96, A68, B24, B07), Medtronic, Minneapolis, MN) placed ventrally in the abdomen, participated in a research study conducted at the University of Louisville. Following enrollment, each participant completed a baseline Urodynamics without stimulation, followed by approximately 8 weeks of bladder mapping. Each participant completed a minimum of 20 urodynamic sessions (10 for storage; 10 for void initiation) mapping the
detrusor and urethral pressure responses as well as sphincter EMG responses during both filling and emptying cystometry phases while scES parameters (anode, cathode selection; frequency and amplitude, and the number of cohorts) were modulated to isolate successful configurations. The goal for bladder capacity (BC)-scES was to target volumes between 400–500 mL based on average normal capacity and avoiding over-distention in those individuals performing intermittent catheterization 4–6 times/day (including average fluid intake). Also targeted were filling pressures (< 10 cmH20) to improve overall bladder compliance and detrusor leak-point pressures (< 40 cmH2O). For the newly implanted patient, it was aimed that the participant exclusively employ scES for bladder management rather than intermittent catheterization. Maintaining normative systolic pressures during filling, within a range of 110–120 mmHg, was a further goal. All enrolled participants completed prior scES mapping studies for cardiovascular function and thus, the cardiovascular cohort was integrated if blood pressure (BP) was elevated. All simulations accounted for any cardiovascular cohorts.