Payvand.com - The first urogenital system operation on patients with a complete spinal cord injury was carried out in Tehran using the innovative procedure adopted by an Iranian doctor, Dr. Mohammad Nabi Nemati who is the head of the surgery department of Bonn university hospital.

Dr. Mohammad Nabi Nemati

According to the health reporter of ISNA the inventor of intra-steep device and the surgeon who carried out this operation in Mehr hospital in Tehran in late August, described his innovative method of operation in an interview with ISNA.

He said: By using this method not only the urination and defecation of the patient will be resolved, but he could also have a normal sexual activity as well, and this could have a positive effect on their living quality.

Dr Nemati added: The first operation of urogenital system on a patient with spinal cord transection, was done on a 35 years old who had an L1 (First Lumbar vertebrae) injury and could walk with difficulty.

He said the operation was done on a semi-open, semi-closed basis and added: This young man can now control his urination and defection and is in constant contact with the surgeon to resolve any possible difficulty with his intra-steep.

The inventor of the urination and defecation device described his method: Patients with complete spinal cord injury, who have deficiencies in movements of upper limbs, have no control on urination and defecation and have usually a loss of sensation in sacral region. With the new method they can control their urination and defecation, but can have normal sexual activity as well and improve their quality of life considerably.

Dr Nemati went on: Normal people are able to control their urination and defecation with the help of contraction and dilation in their anal and vesicle sphincters. In spinal cord transection patients there is a loss of tone in anal and vesicle sphincters and therefore the patient cannot control his urine.

He added: In patients with complete spinal cord injury the outer part of the nerval root exists and are not damaged, but because of the spinal injury could not command the contraction and dilation of sphincters; hence the involuntary urination and defecation.

According to ISNA Dr Nemati then described the mechanism of the device he had invented: This device is comprised of several parts which are woven around the nerval root with 4 probes. The probes are integrated into one flexible probe and inserted in the middle part of the sacral region, by a closed operation or in the outpatient ward. The probe is entered into the spinal canal and woven around the spinal cord where the nerves control the urination and defecation.

He added: The other part of the device is composed of a small transistor with a receiver located in the abdominal area above the pelvis or in sacral region. This part is controlled by with a small transmitter by the patient and activated with electro-magnetic waves. This will stimulate the probe between roots S1 and S4 of the spinal cord and thus permits the patient to stimulate the relevant parts in the spinal cord to control the urination and sexual activities.

Dr Nemati pointed to the fact that some patients do sense their bladder retention while some do not, and added: In both cases, the patients with complete spinal cord injury can use this device to control their senses and the time of their urination and defecation.

ISNA points to the fact that this method has been used on 120 German and Palestinian patients and adds: This device has no side effects and can easily remain in patient’s body. Its battery lasts 10 years and can easily be replaced by a narrow fissure above the abdominal area.

The surgeon from Bonn University Hospital added: The device keeps the anal and vesicle sphincters in contraction by sending electro magnetic waves, and the patient can turn it off when ever he needs to defecate.

He said: The patients can increase the frequency, with doctor’s supervision, to carry out sexual activity.

Professor Nemati said: After three to six months of using this device, the nervous system of the patient will get used to its stimulations and with the return of sensation to the genital organs, he can positively sense bladder retention.

Regarding the costs of this operation he said: The cost is composed of three part: cost of device, hospital costs and surgeon’s cost. The price of the device of Europe and Iran is the same and is 9000 Euros (11 million Tomans). I hope with the mass consumption of intra-steep device its price would fall by half.

Professor Nemati said he is willing to do the surgery for war-disabled patients with complete spinal cord injury free of charge and added: The installation of the device in patient’s body is not a complicated operation and surgeons in Iran can do it easily and try to implement it on war-disabled patients.

He pointed to the fact that the main obstacle in the use of this device is its high price and that there has been talks to reduce the price. He added: The Martyr Foundation and other institutions covering the war-disabled patients and the insurance companies can help a lot in this respect.

This neurosurgery professor pointed to the fact that in European countries the cost for similar surgeries is paid by social insurance institutions and urged the hospitals covered by the Foundation of the War-disabled and the Social Security Services to participate in this process.

In should be added that Dr Mohammad Nabi Nemati visits Iran several times a year and is in contact with Iranian surgeons to practice his innovative surgical techniques.  

Note: Original article published in Persian by ISNA.
Translated for Payvand.com by BMarz translators: http://www.BMarz.com

... Payvand News - 9/24/07 ...