Preliminary study of a genetically engineered spinal cord implant on urinary bladder after experimental spinal cord injury in rats

The objective of this study was to determine the effect of neurotrophin-secreting Schwann cell implants on the urinary bladder after spinal cord contusion. One hour after severe spinal cord contusion at the T8 to T11 level, carbon filaments containing nonsecreting Schwann cells, brain-derived neurotrophic factor (BDNF)-secreting Schwann cells, neurotrophin-3 (NT-3)-secreting Schwann cells, or Schwarm cells secreting both BDNF and NT-3 were implanted into the spinal cord. Untreated spinal cord injured (SCI) rats and noncontused rats (C) were also studied. Two months after spinal cord injury, cystometry was performed and the bladders were studied using light microscopy. SCI rats had significantly increased bladder mass, thickness, and smooth muscle mass compared to C rats. Bladder capacity of SCI rats and rats with spinal cord implants were both significantly greater than that of C rats. This preliminary study suggests that neurotrophin-secreting Schwann cell implants may lead to improved bladder structure after spinal cord injury

The impact of vaginal delivery on pelvic floor function - delivery as a time point for secondary prevention

status: publishe

Therapeutic potential of muscle growth promoters in a stress urinary incontinence model

Weakness of urinary sphincter and pelvic floor muscles can cause insufficient urethral closure and lead to stress urinary incontinence (SUI). Bimagrumab is a novel myostatin inhibitor which blocks activin type II receptors, inducing skeletal muscle hypertrophy and attenuating muscle weakness. β2-adrenergic agonists, such as 5-hydroxybenzothiazolone derivative (5-HOB) and clenbuterol can enhance muscle growth. We hypothesized that promoting muscle growth would increase urethral pressure by facilitating muscle recovery in a dual injury (DI) SUI model. Rats underwent pudendal nerve crush (PNC) followed by vaginal distension (VD). One week after injury, each rat began subcutaneous (0.3ml/rat) treatment daily in a blinded fashion with either bimagrumab (DI+Bim), clenbuterol (DI+Clen), 5-HOB (DI+5HOB) or phosphate-buffered saline (PBS, DI+Sham). Sham-injured rats underwent sham PNC+VD and received PBS (SI). After two weeks of treatment, the rats were anesthetized for leak point pressure (LPP) and external urethral sphincter (EUS) electromyography recordings. Hind limb skeletal muscles and pelvic floor muscles were dissected and stained. At the end of 2 weeks of treatment, all 3 treatment groups had a significant increase in body weight and individual muscle weight compared to both sham treated and sham-injured rats. LPP in the DI+Bim group was significantly higher than LPP of DI+sham and DI+Clen rats. There were more consistent urethral striated muscle fibers, elastin fibers in the urethra and pelvic muscle recovery in DI+Bim rats compared with DI+Sham rats. In conclusion, bimagrumab was the most effective for increasing urethral pressure and continence by promoting injured EUS and pelvic floor muscle recovery

What developments are needed to achieve less-invasive urodynamics? ICI-RS 2019

Aims To assess the state of technologies for urodynamics that are less invasive than standard cystometry and pressure-flow studies and to suggest areas needing research to improve this.Methods A summary of a Think Tank debate held at the 2019 meeting of the International Consultation on Incontinence Research Society is provided, with subsequent analysis by the authors. Less-invasive techniques were summarized, classified by method, and possible developments considered. Discussions and recommendations were summarized by the co-chairs and edited into the form of this paper by all authors.Results There is a full spectrum of technologies available for less-invasive assessment, ranging from simple uroflowmetry through imaging techniques to emerging complex technologies. Less-invasive diagnostics will not necessarily need to replace diagnosis by, or even provide the same level of diagnostic accuracy as, invasive urodynamics. Rather than aiming for a technique that is merely less invasive, the priority is to develop methods that are either as accurate as current invasive methods, or spare patients from the necessity of invasive methods by improving early triaging.Conclusions Technologies offering less-invasive urodynamic measurement of specific elements of function can be potentially beneficial. Less-invasive techniques may sometimes be useful as an adjunct to invasive urodynamics. The potential for current less-invasive tests to completely replace invasive urodynamic testing is considered, however, to be low. Less-invasive techniques must, therefore, be tested as screening/triaging tools, with the aim to spare some patients from invasive urodynamics early in the treatment pathway