Urology / Pelvic Health

Overview

The Pelvic Health program addresses issues of bladder emptying (micturition) and prevention of leakage (continence) in individuals with bladder dysfunction. Bladder dysfunction produces some of the most common complications of individuals with spinal cord injury (SCI), multiple sclerosis and stroke. It can have a devastating impact on an individual’s quality of life. The overall goal of this program is to restore pelvic health to individuals with neurological disease or injury.


 


Electrical Activation of Afferent Nerves to Restore Bladder Function

Purpose: This study uses electrical stimulation to activate or inhibit the bladder in individuals with SCI during urodynamics.

Objective: This program will demonstrate the effectiveness of the ability to control bladder emptying and leakage through FES. This program will be completed upon translation into clinical care.

Principal Investigator: Steven Brose, DO
Contact: Steven Brose, DO
Contact Number: (216) 791-3800 x4707
Contact Email: Steven.Brose@va.gov

 


Afferent Stimulation to Evoke Recto-colonic Reflex for Colonic Motility

Purpose: The investigators are testing the effect of electrical stimulation of the rectum on colonic motility. Most individuals with spinal cord injury develop neurogenic bowel dysfunction, which includes slowed colonic motility, which means that stools take longer than normal to pass through the colon. This slowed movement may result in chronic constipation and difficulty emptying the bowels. Individuals typically (without or without caregiver assistance) insert a gloved finger into the rectum and gently stretch it to improve colonic motility for a brief period to empty the bowels. The investigators hypothesize that electrically stimulating the rectum, instead of mechanically stretching it, will produce the same beneficial effect of improving colonic motility. Therefore, this study will compare the two methods. If electrical stimulation effectively improves colonic motility, then the investigator shall develop the approach as a therapeutic intervention in future studies.

Objective: Compare changes in colonic pressure (cmH2O) over baseline in response to electrical rectal stimulation versus mechanical rectal distension (control) [ Time Frame: 1 month ] [ Designated as safety issue: No ] Two interventions will be tested, including the clinical standard of digital rectal stimulation and a novel approach using electrical stimulation of rectal sensory afferents, to determine the effect on colonic pressure. Increased colonic pressure will indicate successful modulation of neural pathways to increase bowel activity and thereby facilitate defecation in individuals with neurogenic bowel dysfunction.

Detailed program information and criteria available at: https://clinicaltrials.gov/ct2/show/NCT02641483?term=%22bourbeau%22+%22cleveland%22&rank=1

Principal Investigator: Dennis Bourbeau, PhD
Contact: Dennis Bourbeau, PhD
Contact Number: (216) 791-3800 x4845
Contact Email: dbourbeau@fescenter.org