Dr. Christopher Smith, assistant professor of urology at Baylor College of Medicine in Houston, hopes a federally funded study conducted in conjunction with Memorial Hermann/The Institute for Rehabilitation and Research in Houston, will answer the question. BCM is one of 10 sites participating in the national study.

Spinal cord injuries from a variety of accidents affect approximately 250,000 Americans.

“Patients with spinal cord injury often develop a urological dysfunction known as detrusor-sphincter dyssynergia, a condition thought to contribute significantly to the development of bladder overactivity, obstructed voiding patterns, and renal Impairment,” Smith said. “We speculate that injecting Botox® into the urethral sphincter shortly after spinal cord injury will prevent these conditions from evolving.”

Sphincter dyssynergia causes a lack of coordination between the bladder and the sphincter when a person voids. This lack of coordination can increase bladder storage pressure and impair urinary drainage from the kidneys, in some cases leading to permanent kidney damage.

“In order for this process to work, the bladder and the sphincter need to act in a coordinated fashion,” Smith said. “The sphincter muscle should relax when the bladder contracts so that urine can flow normally through the lower urinary tract.”

Botox® is a commercial preparation of botulinum toxin A that works by preventing nerve impulses from reaching the muscle. In this study, Botox® will be injected into the urethral sphincter six weeks after Spinal Cord Injury to relax the muscle and coordinate its action with the bladder.

“We have never looked at using Botox® early after spinal cord injury,” Smith said. “If we find that bladder overactivity is driven by sphincter dysfunction, we can use Botox® to reduce complications associated with detrusor-sphincter dyssynergia.”

Those interested in taking part in this study can contact Sebrina Tello at stello@bcm.edu or 713-798-8106. BCM is recruiting 167 patients. The study will be funded by the National Institute of Neurological Disorders and Stroke. For more information on this trial, visit http://www.bcm.edu/urology/?PMID=4989.