May 31st, 2015 Filed under Urology Research Tagged beaumont, bladder, chinese, education, health, inter-, interstim, ministrelli, spinal, united, urology Comments Off on Urology Research William Beaumont Hospital

Urology research at Beaumont Hospitals is on the cutting edge of clinical practice, aimed at bringing innovative research protocols to patient care, advancing the treatment of disease, improving patient outcomes and enhancing their quality of life. Known as a leader in the field, the department is involved in several innovative studies including interstitial cystitis, urinary incontinence and the prostate gland.

Research projects concentrate on developing novel treatments for urinary incontinence, overactive bladder, pelvic pain, prostate cancer, female reconstructive surgery and neurogenic bladder. These translational and clinical studies along with sponsored pharmaceutical and equipment/device trials offer the opportunity to treat disease states that traditional therapies fail to address. Funded through grants from the National Institutes of Health (NIH), philanthropy including the Ministrelli Program for Urology Research and Education (MPURE), and industry contracts, Beaumont physicians serve as the principal investigators in these national and international trials.

Studies on neuro-urology and incontinence identify and utilize novel therapies such as neuromodulation and nerve re-routing to treat men, women and children who have voiding problems demonstrated to be refractory to standard therapies.

Beaumont Hospitals launched a research study to rewire nerves in the spinal cord in the hope of giving bladder control to people with spinal cord injury or spina bifida who otherwise depend on self-catheterization to urinate. The first procedure garnered national attention and appeared in more than 160 news outlets including U.S.News and World Report, The Washington Post and Forbes. Beaumont is the only institution in the United States to perform this procedure and also provide funding for all the associated costs.

The research at Beaumont uses nerve rerouting to redirect nerves in the spinal cord to gain better control of urination. After the procedure, patients signal the bladder to urinate by scratching or pinching their leg or buttocks. The Chinese doctor who developed the surgery, Chuan-Guo Xiao, M.D., reports an almost 90-percent success rate. The average time it took to see results was 12 to 24 months after surgery, with patients in China reporting better urinary control and improvements in their bowel function.

Beaumont Hospital urologists are first in the United States to research stress urinary incontinence treatment using a persons own stem cells. The stem cells are used to strengthen weak muscles that control urination. If successful, (autologous) muscle-derived stem cell therapy could offer new hope to people and offer them a life free of urinary leakage, says Dr. Peters, who is leading the research at Beaumont. Stress urinary incontinence the cause of wetness with coughing or physical activity affects about 13 million Americans, most of them women, but also men who have had a prostatectomy (surgery for prostate cancer). Current treatments, including medicine, exercises and surgery, are not always effective and may have undesirable side effects. The stem cells from 48 female research participants age 18 or older will be collected at Beaumont Hospital, Royal Oak, and duplicated. The cells will then be injected into the muscles that control urination to strengthen them and prevent leakage.

Participation will last 12-14 months, and will include physical exams, procedures to assess the bladder, completing voiding diaries and questionnaires and a variety of diagnostic tests. A small sample of the participants thigh muscle will be collected, which is the source of the stem cells. Pregnant or nursing women may not participate.

The InterStim a pacemaker-like device used for urinary frequency, urgency and incontinence, is showing promise for treatment of interstitial cystitis symptoms. With the InterStim Therapy, manufactured by Medtronic, Inc., a small electrode is placed adjacent to the sacral nerve. The electrode is externalized and patients monitor their urinary urgency, frequency and pain for two weeks. If the symptoms are at least 50 percent improved, the stopwatch-size power generator is implanted in the upper part of the buttock. The generator is then connected to the previously-placed lead. When the generator produces a small electrical pulse, it stimulates the sacral nerve, helping to control the bladder, sphincter and pelvic floor.

In addition to stimulating the sacral nerve, Urology chairman Kenneth Peters, M.D., is conducting a research study looking at pudendal nerve stimulation using the InterStim device. Thirty subjects were implanted with both sacral and pudendal nerve electrodes. Patients tested each electrode in a blinded fashion. Seventy nine percent of subjects chose the pudendal lead as superior for treating their voiding dysfunction.

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