UBC Theses and Dissertations
Characterizing lower urinary tract dysfunction in a porcine model of spinal cord injury Keung, Sheung Man
Neurogenic lower urinary tract dysfunction after spinal cord injury results in severe morbidity and mortality. Consequences of neurogenic lower urinary tract dysfunction include urinary tract infections, incontinence, upper urinary tract deterioration, and reduced quality of life. Urodynamic studies are the current gold standard for characterizing neurogenic lower urinary tract dysfunction. Currently, there is a need for a large animal model of neurogenic lower urinary tract dysfunction for evaluation of the utility and safety of novel human-sized devices or treatments. In this thesis, the functional and morphologic changes of the bladder were characterized in a porcine model of spinal cord injury. In Chapter 1, I provide background on spinal cord injury and the pathophysiology of neurogenic lower urinary tract dysfunction. I also discuss about the use of animal models for evaluation of human lower urinary tract diseases. In Chapter 2, I pioneered a protocol to perform clinically relevant urodynamic studies in a porcine model of thoracic spinal cord injury. I identified that the pig’s lower urinary tract function is very similar to human bladder function before and after spinal cord injury. In Chapter 3, I describe a protocol to implant radio telemetric devices into a porcine model to characterize physiologic bladder function and to evaluate the practicality of the system. I identified comparable detrusor pressure and external urethral sphincter activity recordings between the urodynamics and telemetry systems before and after spinal cord injury. In Chapter 4, I evaluated the effects of chronic bladder drainage on the functional and histologic features of the bladder. I found high-risk urodynamic features in pigs that received chronic bladder drainage. I have established a protocol to perform urodynamic studies in a porcine model of spinal cord injury to characterize neurogenic lower urinary tract dysfunction. The potential to perform repeated urodynamic studies in a single animal allows for investigation into the efficacy of treatment of therapies and devices over time. This scientific contribution will help bridge the gap between animal experimentation and human application for neurogenic lower urinary tract dysfunction after spinal cord injury.
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