Page 97 - ITPS-7-2

INNOSC Theranostics

and Pharmacological Sciences

ORIGINAL RESEARCH ARTICLE
A pilot study assessing the feasibility and

effectiveness of amniotic bladder therapy in
patients with neurogenic detrusor overactivity

2,3
1
1
Sophie Wittenberg , Codrut Radoiu , Kyle O’Hollaren , Lincoln Erikson ,
1
2
2
1,4
Michael Bush-Arnold , Ali Bitar , Steven Lucas , and Nivedita Dhar *
3,4
1 Department of Urology, Wayne State University School of Medicine, Detroit, Michigan, USA
2 Rehabilitation Institute of Michigan, Detroit, Michigan, USA
3 Detroit Medical Center, Detroit, Michigan, USA
4 John D. Dingell Veterans Affairs Medical Center, Detroit, Michigan, USA
Abstract

Neurogenic detrusor overactivity (NDO) is characterized by involuntary detrusor
contractions that often occur following spinal cord injury (SCI). In addition, patients
with SCI above T6 are at risk for autonomic dysreflexia (AD). Amniotic membranes
(AM) are used for the management of wound healing in multiple medical disciplines.
Thus, this study aims to evaluate the efficiency of amniotic bladder therapy (ABT) in
managing NDO, specifically in patients with SCI. The patients received intra-detrusor
injections under general anesthesia of 100 mg micronized AM (Clarix Flo) diluted
*Corresponding author:
Nivedita Dhar in 10 mL 0.9% preservative-free sodium chloride. Clinical evaluations, including
(ec0362@wayne.edu) maximum detrusor pressure, maximum cystometric capacity, and frequency of
Citation: Wittenberg S, Radoiu AD, were conducted, alongside the completion of questionnaires (Qualiveen
C, O’Hollaren K, et al. A pilot questionnaire) preoperatively and postoperatively at weeks 2, 4, 8, and 12. Eight
study assessing the feasibility and consecutive patients with an average age of 39.6 ± 13.6 years were included. After
effectiveness of amniotic bladder
therapy in patients with neurogenic ABT, a significant decrease in the severity of urinary tract symptoms was observed
detrusor overactivity. INNOSC based on the Qualiveen questionnaire: 3.9 ± 0.17 at baseline to 2.9 ± 0.21 at week 2,
Theranostics and Pharmacological 2.1 ± 0.53 at week 4, and 1.4 ± 0.20 at week 8 (P < 0.01). Improved clinical symptoms
Sciences. 2024;7(2):2037.
doi: 10.36922/itps.2037 were associated with a decreased maximum detrusor pressure, increased maximum
cystometric capacity, and reduced frequency of AD. In conclusion, we investigated ABT
Received: October 14, 2023
as a potential treatment option for NDO associated with SCI. Further investigations
Accepted: November 23, 2023 are warranted to validate the effectiveness of ABT in this patient population and
Published Online: February 29, determine treatment durability.
2024
Copyright: © 2024 Author(s). Keywords: Neurogenic bladder; Neurogenic detrusor overactivity; Autonomic dysreflexia
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution,
and reproduction in any medium, 1. Introduction
provided the original work is
properly cited. Neurogenic detrusor overactivity (NDO) after spinal cord injury (SCI) is a common
Publisher’s Note: AccScience complication, generally characterized by urinary urgency and incontinence, significantly
Publishing remains neutral with impacting normal daily activities and reducing the patient’s quality of life (QoL). In
regard to jurisdictional claims in patients with NDO, achieving a state of low storage bladder pressure along with an increase
published maps and institutional
affiliations in maximum cystometric bladder capacity can improve symptoms of incontinence.

Volume 7 Issue 2 (2024) 1 doi: 10.36922/itps.2037