Beaumont research gives new hope for bladder control

12/18/2006

Beaumont Hospitals has 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.

In spinal cord injury and spina bifida, the nerves that control the bladder and sphincter are damaged. People cannot urinate without the use of a catheter or are constantly wet. Most experience recurrent urinary tract infections. Also, backup of urine into the kidneys can damage these delicate organs. As an end result, kidney dialysis or transplant may be required.

The research at Beaumont uses nerve rerouting, a surgery pioneered in China, to redirect nerves in the spinal cord to gain better control of urination. 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 12-24 months after surgery. Patients in China report better urinary control and improvements in their bowel function. They signal the bladder to urinate by scratching or pinching their leg or buttocks.

"We performed the first nerve rerouting surgery at Beaumont on Monday, Dec. 18, for a 48-year-old man from Fenton," says Ananias Diokno, M.D., executive vice president and chief medical officer for Beaumont Hospitals. "As you can imagine, he's very excited at the prospect of gaining greater independence and regaining control of his life."

Possible side effects of the surgery include mild postoperative spinal fluid leakage and headache. Recent changes in the surgical technique have dramatically decreased the incidence of these complications. Standard risks associated with any surgery may include bleeding and infection.

Tests that are done in connection with the surgery are: MRI of the spine; blood work; urinalysis; urodynamic testing that involves inserting a catheter into the bladder; examination by a neurologist; evaluation of nerve function; bladder and kidney ultrasound; cystoscopy (insertion of a tube into the urinary tract to examine it); and completion of questionnaires and bladder diaries.

The surgical team working with Dr. Xiao at Beaumont includes Dr. Diokno; Kenneth Peters, M.D., research director for Beaumont's Urology department; and Jose Gonzalez, M.D., Beaumont urologist.

Call study coordinator Cindy Turzewski, R.N., at 248-551-3355 or e-mail her at cynthia.turzewski@beaumont.edu for more information.

This research is funded by the Ministrelli Program for Urology Research and Education.

In addition to nerve rerouting surgery, Beaumont urologists offer expertise in pediatric urology, male infertility, prostate gland diseases, urologic cancer, urinary incontinence, urologic stone disease, sexual dysfunction, prosthesis surgery, genital reconstruction, laser and lithotripsy. Specialized diagnostic services are available in urodynamics, erectile dysfunction evaluation, prostate ultrasound and comprehensive stone evaluation. The department is actively involved in clinical drug research and the testing of investigational urologic devices. Beaumont Hospital in Royal Oak was named 23rd on U.S. News and World Report's 2006 list of top hospitals for urology.