AccScience Publishing / ITPS / Volume 7 / Issue 2 / DOI: 10.36922/itps.2037
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A pilot study assessing the feasibility and effectiveness of amniotic bladder therapy in patients with neurogenic detrusor overactivity

Sophie Wittenberg1 Codrut Radoiu1 Kyle O’Hollaren1 Lincoln Erikson2,3 Michael Bush-Arnold2 Ali Bitar2 Steven Lucas1,4 Nivedita Dhar3,4*
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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
INNOSC Theranostics and Pharmacological Sciences 2024, 7(2), 2037
Submitted: 14 October 2023 | Accepted: 23 November 2023 | Published: 29 February 2024
© 2024 by the Author (s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution -Noncommercial 4.0 International License (CC-by the license) ( )

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 in 10 mL 0.9% preservative-free sodium chloride. Clinical evaluations, including maximum detrusor pressure, maximum cystometric capacity, and frequency of AD, were conducted, alongside the completion of questionnaires (Qualiveen questionnaire) preoperatively and postoperatively at weeks 2, 4, 8, and 12. Eight consecutive patients with an average age of 39.6 ± 13.6 years were included. After ABT, a significant decrease in the severity of urinary tract symptoms was observed based on the Qualiveen questionnaire: 3.9 ± 0.17 at baseline to 2.9 ± 0.21 at week 2, 2.1 ± 0.53 at week 4, and 1.4 ± 0.20 at week 8 (P < 0.01). Improved clinical symptoms were associated with a decreased maximum detrusor pressure, increased maximum cystometric capacity, and reduced frequency of AD. In conclusion, we investigated ABT as a potential treatment option for NDO associated with SCI. Further investigations are warranted to validate the effectiveness of ABT in this patient population and determine treatment durability.

Neurogenic bladder
Neurogenic detrusor overactivity
Autonomic dysreflexia
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Conflict of interest
The authors have no relevant conflict of interest to disclose.
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INNOSC Theranostics and Pharmacological Sciences, Electronic ISSN: 2705-0823 Published by AccScience Publishing