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

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

Projects

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.

Basic research

The work of the SCI-TReCS urology team focuses on the following basic research areas:

Definition of the ideal nerve for neuromodulation of the bladder, including determination of the best possible electrode type, with simultaneous research on the least invasive and safest implantation techniques for neurogenic bladder dysfunction disorders:

Ex vivo and in vivo studies are being conducted in pigs, wherein the research emphasis of the University Clinic is the minimally invasive laparoscopy technique under the direction of Dr. Günter Janetschek.

In the tissue regeneration area, the action mechanisms of low-energy extracorporeal shock waves are being studied in healthy and damaged tissue. The action principle of shock waves is still not fully understood. But they are believed to have a high regenerative potential. In wound-healing and bone-healing disorders and also in the treatment of areas of myocardial ischemia, good tissue regeneration results have already been achieved in studies.

Cardiac shock wave therapy has become a standard procedure for treating poor myocardial blood flow. In rats and pigs and also in SCI rats, we are analyzing the effects of shock wave therapy on various tissues at the structural level and studying the cellular interrelations of regeneration. Muscle tissue and the erectile tissue of the penis are the targets.

Translational research

In translational research, the preliminary results of basic research are taken and used in chronic studies, in order to ensure greater validity as well as transferability to patients. We use the pig as a model, as it is the most suitable animal model in this context.  In the paraplegia research track and with the miniature pig as a suitable model, we are investigating the chronic stimulation of peripheral nerves over the longer term. The focus here is on stimulation efficacy, protection of the upper and lower urinary tract, and electrode functionality.

In the tissue regeneration area and with the pig as a model, we are investigating the influence of shock wave therapy on erectile dysfunction and in particular which cellular changes are responsible for the already partially known clinical effects. Such investigations have never been performed before.

In another translational project, in cooperation with the Institute of Anatomy, Histology, and Embryology of the Innsbruck Medical University we are trying to determine the optimum access and site for an electrode implant in paraplegic patients in the scope of an anatomical study.

We are studying the nerve pathways and optimum accessibility in prepared samples in preparation for the planned clinical implementation of different nerve stimulation techniques and to create the best possible conditions for the planned surgical procedures. By doing so we should achieve a safe and reliable stimulation electrode implantation, as we believe that neuromodulation will play a key role in the context of treatment and regeneration.

Clinical research

In the clinical research field, we are currently focusing on the area of bladder neuromodulation. In a multi-center study in collaboration with clinics in other countries and on the basis of preliminary positive results, the optimum treatment time for bladder neuromodulation is being investigated and the effect of neuromodulation on bladder function is being monitored as part of a long-term observation.

Part of this study consists of developing a tissue data bank for collecting samples of various urogenital tract organs and providing an overview of the diverse patterns and stages of damage. This tissue data bank is decisive for ultimately understanding which disorders occur at different times as well as when it is still possible to influence these changes.

We are concentrating in particular on paraplegic patients, but also on tissue from patients with other non-neurogenic and neurogenic bladder function disorders. The latter will be compiled to form a standardized data bank. Thanks to this data bank a longitudinal comparison and a survey of urogenital tract damage patterns as a whole will be possible, thus granting doctors worldwide access to this invaluable histopathological analysis information. Over the long term, the tissue data bank will be a major resource for therapy development in paraplegia research. Only when the injury patterns and the progress over time are known does it then become possible to develop suitable therapies or assess the potential protective value of various measures.