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Detrusor Activity Recovery in Acute Traumatic Spinal Cord Injuries

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details.
 
ClinicalTrials.gov Identifier: NCT05207826
Recruitment Status : Not yet recruiting
First Posted : January 26, 2022
Last Update Posted : January 26, 2022
Sponsor:
Collaborator:
Coloplast A/S
Information provided by (Responsible Party):
Sungchul Huh, Pusan National University Yangsan Hospital

Brief Summary:
Determining the most appropriate time to evaluate detrusor activity in urodynamic studies for both traumatic and non-traumatic spinal cord injuries

Condition or disease Intervention/treatment
Spinal Cord Injuries Neurogenic Bladder Spinal Shock Diagnostic Test: Cystometrogram

Detailed Description:

The detrusor activity in the acute phase of the spinal cord injury changes with the development of the spinal shock. Spinal shock is a phase of areflexic phase after the spinal cord injury that is primarily influenced by the severity of the injury and the neurological level of injury. Detrusor activity shows areflexic in the spinal shock phase, followed by a return of detrusor activity at the end of the spinal shock.

There was no recent study to provide evidence of an appropriate time to assess detrusor muscle activity through urodynamic studies. There were only a few limited studies on detrusor activity following spinal cord injury from 1960 to 1970. However, when the urodynamic study should be performed is still controversial.

Knowing the patterns of detrusor activity following spinal cord injuries is critical to determining the appropriate timing for intermittent catheterization, which is the standard emptying method of choice. If clinicians fail to understand true detrusor activity as early as possible, the patient will suffer from unnecessary indwelling catheter voiding, resulting in impaired quality of life in the acute phase.

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Study Type : Observational [Patient Registry]
Estimated Enrollment : 30 participants
Observational Model: Case-Only
Time Perspective: Prospective
Target Follow-Up Duration: 2 Years
Official Title: Determining the Most Appropriate Time to Evaluate Detrusor Activity Recovery in Acute Traumatic Spinal Cord Injuries
Estimated Study Start Date : March 1, 2022
Estimated Primary Completion Date : December 31, 2023
Estimated Study Completion Date : December 31, 2023



Intervention Details:
  • Diagnostic Test: Cystometrogram
    Serial cystometrogram every 3 days for acute traumatic spinal cord injured patients


Primary Outcome Measures :
  1. Detrusor activity recovery [ Time Frame: Every 3 days in spinal shock phase (up to 3 months) ]
    Pressure change (Detrusor pressure change in filling cystometrogram)


Secondary Outcome Measures :
  1. Reflexes [ Time Frame: Every 3 days in spinal shock phase (up to 3 months) ]
    Superficial reflex and pathologic reflex (Cremasteric reflex, Dartos reflex, BC reflex, anal reflex, Babinski reflex, delayed plantar reflex)



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years to 75 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Sampling Method:   Non-Probability Sample
Study Population
Acute traumatic spinal cord injuries
Criteria

Inclusion Criteria:

  • Acute onset suprasacral spinal cord injury with both traumatic and non-traumatic causes within the first 15 days after spinal cord injury(very acute phase of SCI according to European Multicenter Study about SCI : the first 15 d (very acute), between 16-40 d (acute I), and 3 mo (acute II), 6 mo (acute III), and 12 mo (chronic) after SCI)
  • Age older than 18
  • Inpatient
  • Patients with spinal cord injuries who initially keep the indwelling catheter
  • Patients with or without spinal shock

Exclusion Criteria:

nstable vital sign (using Inotropics or vasopressors or antiarrhythmic agents)

  • Current urinary tract infection
  • Agitated behavior (Richmond Agitation and Sedation Scale of +2 to +4)
  • Decreased mentality (RASS of -2 to -5)
  • Concomitant sacral lesions (Ex. Sacral fracture, pelvic bone fracture, urologic trauma)
  • Concomitant supraspinal lesions (Ex. Traumatic brain injury, old stroke, Parkinson disease)
  • Uncontrolled DM
  • Medical history of lower urinary tract dysfunction (Ex. BPH, Malignancy)
  • Uncontrlled autonomic dysreflexia (In case of autonomic dysreflexia, defined according to ISAFSCI (International Standards to document remaining Autonomic Function after SCI) as an increase in systolic blood pressure 20 mm Hg or greater from baseline

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT05207826


Contacts
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Contact: Sungchul Huh, PhD +82-10-9354-2177 dr.huhsc@gmail.com
Contact: Sang Hun Kim, PhD +82-10-3877-8356 kel5504@gmail.com

Sponsors and Collaborators
Pusan National University Yangsan Hospital
Coloplast A/S
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Responsible Party: Sungchul Huh, Assistant professor, Pusan National University Yangsan Hospital
ClinicalTrials.gov Identifier: NCT05207826    
Other Study ID Numbers: DRASS
First Posted: January 26, 2022    Key Record Dates
Last Update Posted: January 26, 2022
Last Verified: January 2022
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Spinal Cord Injuries
Urinary Bladder, Neurogenic
Wounds and Injuries
Spinal Cord Diseases
Central Nervous System Diseases
Nervous System Diseases
Trauma, Nervous System
Neurologic Manifestations
Urinary Bladder Diseases
Urologic Diseases
Female Urogenital Diseases
Female Urogenital Diseases and Pregnancy Complications
Urogenital Diseases
Male Urogenital Diseases