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My research has primarily been clinically oriented and relates to neurologic relationships in the genitourinary tract. A fundamental aspect of investigation focuses on neurophysiologic assessment of disordered function due to trauma, infection, inflammation, prostate growth, or behavior abnormalities. I have investigated the urologic management and outcome after spinal cord injury. Current clinical research focuses on management of chronic pelvic pain utilizing drug trials and physiotherapy, new medical devices including electrical stimulation, and microdelivery of pharmaceutical agents.
Safety and Efficacy of botulinumA Toxin (BotoxA) for Treatment of Neurogenic Bladder of Parkinson's Disease
The basic nerve deficit of Parkinson's disease (PD) leads to lower urinary tract symptoms of
frequency, urgency and urge urinary incontinence. Lower urinary tract symptoms tend to occur
at more advanced stages of PD. In the over-65 year old age group, where 1% of men suffer from
this disease, they are also prone to development of benign prostatic hyperplasia (BPH) and
consequent associated lower urinary tract dysfunction. Similarly the over 65-year age group
develop spontaneous overactive bladder up to a prevalence of 30% of both men and women. The
urologic disorder is exceedingly devastating in reducing the quality of life in these
individuals due to the lower urinary tract symptoms and ultimate urinary incontinence in a
high proportion of patients.
While attempts at pharmacologic treatment are partially satisfactory many patients are
intolerant of oral drugs.
Botulinum-A neurotoxin (BTX-A) has been shown in pilot trials to be quite effective in
reducing overactive bladder symptoms and is specifically beneficial for a wide-variety of
neurogenic bladder causes of over activity . The treatment procedure of injecting the
detrusor muscle of the bladder with BTX-A is quite simple, does not impose significant risks
to the patient, and can be performed as an office urologic procedure.
This pilot clinical trial intends to demonstrate the safety and efficacy of low-dose Botox-A
injections into the bladder to improve urinary symptoms in 20 patients.
Stanford is currently not accepting patients for this trial.
For more information, please contact SPECTRUM, .
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