SCI-TReCS - Spinal Cord Injury and Tissue Regeneration Center Salzburg

SCI-TReCS - Spinal Cord Injury and Tissue Regeneration Center Salzburg

University Clinic of Urology and Andrology

Urology plays a key role in the treatment and aftercare of paraplegic patients. Protection of the lower and upper excretory system is an essential aspect in terms of providing patients with a good quality of life. 

Consequences of spinal cord injury

A spinal injury causes irreversible damage to the bladder over the medium and long term. The bladder ceases to function normally. An immediate consequence of a spinal cord injury is an areflexic bladder. This leads to excessive pressure on the sphincter muscle and then in the bladder. Control of emptying or bladder function is no longer possible. The bladder shrinks as a consequence. The excessive pressure in the bladder leads to a back flow of urine via the ureters into the kidneys (vesicouretal reflux). Over the long term this leads to kidney damage and thus to the destruction of the entire excretory and urine storage system.

Although not evident at first glance, the consequences of paraplegia to the urinary system pose one of the greatest dangers to the patient. Morbidity and quality of life are severely impacted. A two-fold therapeutic approach is required: prevention of irreversible damage to the detrusor muscle on one hand and maintenance of normal bladder function (storage and emptying of urine) on the other.

Key research focuses

Key research focuses include research on curing neurogenic bladder dysfunction in paraplegic patients and research on therapeutic approaches to targeted bladder modulation and protection of the upper urinary tract. Electrical stimulation of the peripheral nerves of the bladder for emptying was introduced in the 1970s and, thanks to ongoing research, has since evolved into bladder neuromodulation in order to maintain physiological bladder functions and protect the upper urinary tract.    

These approaches are gaining acceptance, especially in view of the aspect of a potential reversibility of the spinal injury. The aim is to at least curtail the changes to the urinary tract, which normally occur randomly, and thus maintain the system and the functionality thereof for a potential rehabilitation at a later date and protect kidney function. Even if it is not possible to influence bladder functionality directly, the notion of preventing the aforementioned changes is still a key research focus. The ultimate long-term goal is to restore the functionality and voluntary control of the bladder.

The work of the University Clinic of Urology in the Spinal Cord Injury and Tissue Regeneration Center Salzburg (SCI-TReCS) encompasses basic, translational, and clinical research.