In conjunction with the James J. Peters VA Medical Center, physicians at Mount Sinai are evaluating the Neuro-Control Vocare® bladder stimulator device for treatment of neurogenic bladder in spinal cord injury patients. This multidisciplinary study, including the SCI service, Urology, Neurosurgery and Gastroenterology, offers SCI patients with complete injuries the chance to have an electronically controlled stimulator implanted within the spinal cord. The five successfully implanted patients are all voiding normally using the stimulator, making it the second most active U.S. site. This work is a collaborative effort between the departments of urology, neurosurgery and gastroenterology.
In conjunction with the James J. Peters VA Medical Center, Mount Sinai is the largest U.S. site having completed evaluation of the BladderMANAGER®, a portable ultrasound device used to determine urinary bladder volume in Spinal Cord Injury patients.
Physicians at Mount Sinai are conducting a study comparing a new hydrophilic coated catheter (LoFric®) to a standard plastic catheter in patients performing intermittent self-catheterization for neurogenic bladder dysfunction. The hydrophilic coating reduces friction, thereby potentially reducing the incidence of trauma and infection. This study is funded by the Astra Tech corporation of Sweden, the manufacturer of the LoFric® catheter, and is being performed in conjunction with the Department of Rehabilitation Medicine.
The Mount Sinai Department of Urology has been chosen to participate in a multi-center U.S. study comparing the use of Tolterodine (Detrol®), a new anticholinergic agent, with or without an estrogen-containing vaginal ring, in the treatment of mixed urinary incontinence. This new anticholinergic medication has been shown to be effective in the treatment of the overactive bladder, with less side effects than oxybutinin, the most commonly prescribed anticholinergic agent.
Physicians at Mount Sinai have been using a new material, (Alloderm®), in the performance of pubovaginal sling procedures for severe female stress urinary incontinence. This inert product, manufactured from cadaveric skin, saves time in the operating room by eliminating the need for a large abdominal incision. In addition, it integrates into the patient's body without an allergic or inflammatory response. Hospital stays have been reduced to 2 days or less, and our preliminary results, including cure rate and patient acceptance, are quite encouraging.
Physicians at Mount Sinai are also in the process of testing a particulate form of Alloderm® in the bladders and urethras of experimental animals. If successful in the laboratory, this product could be used as an injectable substitute for collagen in the treatment of instrinsic sphincter deficiency or vesico-ureteral reflux.