Grant: Doctoral: Vanier Canada Graduate Scholarships

In spinal cord injury (SCI) the nerves that communicate between the brain and body are damaged. In addition to patients experiencing weakness and numbness of the extremities, patients often experience a loss of bladder control. For people living with SCI, loss bladder control is one their most significant challenges affecting their quality of life. Despite medications, catheters, and surgical options, individuals with SCI still struggle with issues relating to their lack of bladder control, such as urinary incontinence and difficulty emptying. Additionally, people living with SCI can experience severe complications as a result of this bladder dysfunction, such as urinary tract infections or even damage to the kidneys themselves (leading to kidney failure). Therefore, a new approach to improve bladder function after SCI is needed. One such innovative approach to address bladder dysfunction is sacral neuromodulation (SNM), which involves surgical implantation of electrodes alongside the sacral nerves in the lower back near the tailbone. These sacral nerves mediate control of bladder function. Studies have shown that treatment with SNM can improve urinary continence (and therefore improve the ability of the bladder to store urine), and also has the potential to help with bladder emptying. SNM is a clinically available therapy for able-bodied people who suffer bladder control problems, but has not been widely studied or used in people who have a spinal cord injury, where the nature of bladder control problems are different in some ways. The goal of this study is to evaluate the effects of different patterns of SNM on urinary continence and bladder emptying in a unique large animal model of SCI, with the expectation that what we learn from the animal model can be then translated to initiate a clinical study of SNM in humans living with SCI.