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Urogenital and Bowel CORE »

Urogenital and Bowel C.O.R.E.

Scientific Co-Directors:

Manager:

April Herrity, DC, PhD
Assistant Professor
April.Herrity@louisville.edu

 

 

 

 

 

Jennifer “Erin” Wyles
Coordinator
Jennifer.Wyles@louisville.edu

Comprehensive

The Urogenital & Bowel Scientific Core takes a comprehensive approach to the care and study of issues related to bladder, bowel or sexual dysfunction in individuals with spinal cord injuries. We work collaboratively across multi-disciplinary research and clinical teams that include experts in neurology, gastroenterology, neurosurgery, and rehabilitative services, so we can provide optimal care for our research participants. Our scientists and clinicians have experience working with individuals with spinal cord injuries and we combine excellent clinical care with scientific expertise in a compassionate environment.

Objective

We design protocols using standard medical and research equipment to obtain objective assessments of urogenital and bowel functions. These assessments are essential to helping us better understand, improve and ultimately overcome dysfunction in these areas.

Bladder Function Assessments

  • Questionnaire: adapted from an internationally accepted standardized questionnaire (Biering-Sorenson, F. et al. (2008) Spinal Cord 46:325-330, 513-516) our bladder function questionnaire is used to assess overall bladder health and management
  • Bladder Diary: an individual’s record of liquid intake and urine output provides valuable insight into kidney and bladder function and use of our bladder diary complements our lab-based assessments
  • Uroflowmetry: measures the amount and monitors the pattern of (speed, constant or interrupted) urine voided during urination; also can signal presence of a blockage
  • Cystometrogram (CMG): assesses bladder and abdominal muscle behavior while urine is stored and while urine is passed, and includes a measurement of bladder pressure
  • Electromyography (EMG): small sensors placed near the urethra or rectum measure the strength and electrical activity of muscles and nerves in and around the bladder and sphincters (the pelvic floor)
  • Bladder and Kidney Ultrasound: a noninvasive technique that transmits sound waves through the body; images of the bladder and kidneys help to assess damage from chronic high pressure in the bladder and potential backflow of urine into the kidneys (urinary reflux)

Bowel Function Assessments

  • Questionnaire: adapted from an internationally accepted standardized questionnaire (Krogh, K. et al. (2009) Spinal Cord 47:230-234) our bowel function questionnaire is used to assess overall bowel health and management of fecal elimination
  • Anorectal Manometry (ARM): evaluates bowel function in individuals that have difficulty moving the bowels and/or experience stool leakage. It measures the strength of the anorectal and external anal sphincter muscles, sensation of stooling in the rectum as well as the neural reflexes necessary for bowel function

Sexual Function Assessments

  • Questionnaires: standardized questionnaires are used to assess overall sexual health and management in both males (adapted from Rosen, R. et al. (2006) Urology 68 (Suppl 3A): 6-16 and Alexander, M. et al. (2011) Spinal Cord 49: 795-798) and females (adapted from Alexander, M. et al. (2009) The Journal of Spinal Cord Medicine 32 (3): 226-236 and Alexander, M. et al. (2011) Spinal Cord 49: 787-790)

What to Expect During Testing

  • Our experienced nurses perform assessments in private, dedicated evaluation rooms
    • Any special preparations or requirements, such as stopping certain medication, is communicated prior to testing
  • A medical history interview and physical exam are performed prior to any testing
  • Blood pressure and heart rate are monitored throughout any testing
Research-driven

We employ a “Discovery-to-Recovery” approach and work closely across disciplines to expand knowledge and bring innovative treatments to practice so that individuals with spinal cord injuries can experience their own personal Victory Over Paralysis. Our work is published in leading scientific journals and copies of our most recent articles are available by clicking here.

Evidence-based

The majority of individuals with SCI experience neurogenic dysfunction that affects the urogenital system and bowels. The assessments we perform are leading to greater understanding of how we can use interventions such as Locomotor Training (LT), Neuromuscular Electrical Stimulation (NMES) and spinal cord Epidural Stimulation (scES) to regain function and improve quality-of-life for individuals with spinal cord injuries.