Areas of Research
Overactive Bladder (OAB)
Underactive Bladder (UAB)
Voiding Dysfunction
Neurourology
Artificial Urinary Sphincter for the treatment of (Male/Female) Stress Urinary Incontinence
Urogynecology/Female Pelvic Medicine and Reconstructive Surgery
Transitional Urology: adults with congenital genitourinary abnormalities
Minimally Invasive Pelvic Surgery: pelvic organ prolapses, urinary fistulas
Active Research Projects
The multidisciplinary nature of our focused Research Lab has been the major strength of our research since we began our work in 2000. Keep reading to find out what we are currently investigating.
MS Bladder Trial
This phase II randomized double-blind sham-controlled single center clinical trial is designed to evaluate the effects of targeted repetetive transcranial magnet stimulation (rTMS) in patients with Multiple Sclerosis (MS) by investigating restorative reorganization of brain function and improvement of urinary frequency, urgency and incontinence. (ACTIVELY RECRUITING)
Suprapubic Bulbocavernosus Reflex Stimulation
Functional MRI (fMRI) can be used to study the brain, but it's difficult to study the spinal cord. A new low-cost device was developed to study the spinal cord's neural pathways controlling bladder function by tapping the suprapubic region instead of inducing the bulbocavernosus reflex through more immodest means. The device has received clearance for testing in healthy and injured participants and can help researchers explore mechanisms controlling urinary, digestive, or sexual function in the sacral spinal cord region.
Understanding Bladder Control Through fMRI Imaging
The overall objective of this study is to use high-resolution neuroimaging (7-Tesla functional magnetic resonance imaging (7T fMRI)) to characterize brainstem regions that are proposed to be activated during continence and micturition in healthy men and women with a novel and noninvasive MRI paradigm. This seminal research will be the first 7T fMRI study evaluating the brain and specifically the brainstem control of bladder function, creating the seminal high- quality database for future studies in patients with lower urinary tract dysfunctions.
Procedureal Discomfort Related to Intradetrusor Botox Injections
In this study, we propose two different protocols to study patient-centered outcomes related to procedural discomfort, symptom relief, adverse events, and effectiveness under ‘real world’ conditions. Given the lack of data for procedural optimization, especially in the neurogenic population, the goal of this study is to determine the optimal plan for Botox injections into the bladder's detrusor muscle to achieve the best therapeutic effect in patients afflicted with neurogenic bladder.
Supraspinal Targets in Neurogenic Voiding Dysfunction
As part of an ongoing clinical trial, we have identified brain regions involved at voiding initiation and are investigating the effectiveness of targeted, noninvasive, cortical modulation (using Transcranial Rotating Permanent Magnet Stimulation) in multiple sclerosis (MS) patients to improve their bladder symptoms and restore their brain activation patterns.
Brain Control of the Bladder
Our lab's primary research focuses on understanding the brain correlates of the bladder cycle in healthy individuals and in patients with lower urinary tract dysfunction (neurogenic and non-neurogenic). Our team has developed and refined a concurrent urodynamic/fMRI neuroimaging platform to evaluate brain control of bladder filling and voiding where the bladder is filled followed by individuals voiding (or attempt of voiding) actively in the scanner.
Quality of Life after Bladder Surgery in Neurogenic Bladder Patients
This study prospectively evaluates both the subjective changes in outcomes and the objective changes in urodynamic parameters after intra-detrusor injections of onabotulinumtoxinA (Botox®) in adults with congenital spinal dysraphism such as spina bifida.
Transcutaneous Tibial Nerve Stimulation for Acute and Chronic Spinal Cord Injury Neurogenic Bladder
This prospective, longitudinal, multi-institutional assesses the outcomes after reconstructive bladder surgery such as augmentation cystoplasty or urinary diversion. This is a NBRG sponsored trial.
Completed Research Projects
Higher Neural Changes following Medications used for Overactive Bladder Management
Intra-detrusor Injections of Botulinum Toxin-A in Adults with Myelomeningiocele
Clinical outcomes of patients with congenital genitourinary anomalies, such as spina bifida
Assessment of female stress urinary incontinence
Higher Neural Contribution Underlying Lower Urinary Tract Symptoms in Men with Benign Prostatic Hyperplasia Undergoing Bladder Outlet Procedures
Deep brain stimulation in patients with lower urinary tract symptoms
Treatment of overactive bladder with BOTOX® versus tibial nerve stimulation
Dysport treatment in patients with neurogenic urinary incontinence
