Spinal cord stimulator restores bladder control
A UCLA researcher is working on a treatment that may restore an ability most people lose after spinal cord injury.
It’s noninvasive, inexpensive, painless and had promising results in its first clinical trial.
More than 80 percent of Americans who suffer spinal cord injuries lose the ability to urinate and have to rely on catheters to empty their bladders. That can be time-consuming, inconvenient and can lead to infections and even death.
Now, researchers are testing a new way to restore bladder control.
Twenty-nine-year-old Hinesh Patel broke his neck and damaged his spine when he fell off a balcony last year.
The M.D., Ph.D student has traveled the world and was super active. He’s getting back mobility, but so far, not the ability to urinate without a catheter.
“Now, you really have to think about that, because if you don’t manage it well, then you can also get worse health problems,” he said.
UCLA Dr. Daniel Lu is running his second study using a magnet to stimulate the part of the spinal cord that controls bladder function.
“The injury’s oftentimes not a complete injury," Lu said. "There are residual pathways still connected past the injury point.”
In the first study, five men got magnetic stimulation for 15 minutes a week. After four months, two stopped using a catheter completely, two had substantial improvement and one had moderate improvement.
“It modifies the signal in such a way that it became functional, that the neurons and circuits at the spinal cord level can interpret that as a viable signal,” Lu said.
Hinesh is in Lu’s second trial. He’s gone in for 15 minutes twice a week for four months. It’s a blinded study, so he doesn’t know if he’s actually getting treatment but believes he’s regaining sensation.
“Just means more control over your life in that regard,” Patel said.
The magnetic stimulation device is FDA-approved but is experimental for this particular use. In the second study of 15 men and women, Lu is hoping to find out why the magnets work better on some people than others and what doses provide the best and longest-lasting results.
In the first trial, the positive effects started degrading a few weeks after treatment stopped.
TOPIC: SPINAL CORD STIMULATOR RESTORES BLADDER CONTROL
REPORT: MB #4504
BACKGROUND: A spinal cord injury may not only affect your back; it can affect other muscles in the body as well. The location of the injury also affects the type of bladder condition that you might have. More than 250,000 people in the U.S. live with spinal cord injuries; 80 percent of them cannot urinate voluntarily. The brain loses control and steering of urination when the spinal cord is damaged. If the injury occurs above the anatomical level of vertebra TH 12/L1, then you could have detrusor-sphincter dyssynergia. This means that your bladder and sphincter would be working against each other causing infection, incontinence, and possible major damage to your kidneys. If the injury is below or at the vertebra, you could lose muscle tone in the bladder and sphincter. This results in retention, incomplete emptying of the bladder, urinary tract infections or overflow.
POSSIBLE SOLUTIONS: If the injury is below that vertebra, then the solution could be Clean Intermittent Catheterization (CIC). This option is the closet a person will ever get to the natural way of urination. There is also an intermittent Catheterization Program (ICP). This would empty the bladder every four to six hours, but there are a few complications. Since catheters must be inserted into the body, bacteria can also get inside the body. They can be life threatening if not sanitized properly.
(Source: https://www.wellspect.com/bladder/about-cic https://www.christopherreeve.org/living-with-paralysis/health/secondary-conditions/bladder-management
NEW TECHNOLOGY: There have been recent developments that are being tested to try to solve this problem. Magnetic stimulation has allowed patients to recover some bladder control for up to four weeks. In the first study, all five men were able to urinate alone, while another was able to not have to use his catheter at all. The men that participated in the study said that it improved their quality of life by 60 percent. If the results of the second study are repeated then bladder care could be changed in clinics and at home.