Urinary Incontinence Clinical Trial
Official title:
Lumbar to Sacral Ventral Nerve Re-Routing
To assess the level of improvement in voiding function after lumbar to sacral ventral nerve re-routing procedure in Spinal Cord Injury and spina bifida patients
Spinal cord injury (SCI) and spina bifida is a source of irreversible injury to the spinal
cord often resulting in paralysis and loss of sensation below the waist. The inability to
urinate normally is a consequence of both conditions (neurogenic voiding dysfunction). In
spina bifida and spinal cord injury, the nerve that controls the bladder and sphincter (the
muscle that squeezes the bladder neck to prevent leaking) may no longer work properly
resulting in patients who cannot urinate or are constantly wet.
Most patients will maintain high pressures in their bladder and these elevated pressures
will eventually take its toll by causing recurrent urinary tract infections, backup of urine
to the kidneys, and marked dilatation of possible further damage to the kidneys. Many
patients eventually suffer from irreversible renal (kidney) damage, where dialysis or kidney
transplant is the only way to sustain life.
Spinal bifida (present at birth) and SCI (occurs most often early in the fourth decade of
life) predominately affect young individuals and longevity and quality of life may be
greatly reduced by the presence of bladder, bowel, and sexual dysfunction. In the recent
past, medications and catheters were the only way to help cord injured patients empty their
bladders. Although clean intermittent catheterization (CIC) provides good maintenance
results, medications can help conserve low bladder pressures, and antibiotics sustain an
infection free urinary tract, these are difficult bladder management programs to uphold.
They are expensive, time consuming, and outcomes are inconsistent.
A new surgical procedure has potential for treatment of spinal cord injuries/ spinal bifida.
Recently, Dr. Chuan-Guo Xiao from China developed a surgical procedure of rewiring the
nerves in the spinal cord to gain better control of urination and avoid complications of
neurogenic bladder. The procedure reconnects live wires (nerves) to dead wires.
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Endpoint Classification: Efficacy Study, Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Treatment
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