10 Participants Needed

Neo-Bladder Augmentation for Neurogenic Bladder

MD
Overseen ByMary-Clare Day, RN, BSN
Age: 18 - 65
Sex: Any
Trial Phase: Phase 2
Sponsor: Wake Forest University Health Sciences
Must be taking: Anticholinergics
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Prior Safety DataThis treatment has passed at least one previous human trial

Trial Summary

What is the purpose of this trial?

The purpose of this research study is to find out if autologous "neo-bladder" construct for the treatment of fibrotic and/or contracted bladder can improve bladder compliance and be safe long term. The neo-bladder is like a reservoir or pouch that will be surgically attached to the bladder to assist with urine collection.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications. However, it mentions that participants should have failed to respond to the maximum approved dose of medical therapy or have a contraindication to such agents, which might imply some changes to your current medication regimen.

What data supports the effectiveness of the treatment Neo-Bladder Construct for neurogenic bladder?

Research shows that bladder augmentation, a similar treatment, can significantly increase bladder capacity and reduce pressure in patients with neurogenic bladder, leading to improved continence. This suggests that Neo-Bladder Construct may also be effective in managing neurogenic bladder symptoms.12345

Is bladder augmentation generally safe for humans?

Research shows that bladder augmentation, including techniques like sigmoid bladder augmentation, has been studied for safety in conditions like neurogenic bladder and spina bifida. These studies generally support its long-term safety, although specific risks and complications can vary depending on individual health conditions.12678

How is the Neo-Bladder Construct treatment different from other treatments for neurogenic bladder?

The Neo-Bladder Construct treatment is unique because it involves creating a new bladder using tissue engineering techniques, which may offer a more natural and potentially less invasive alternative to traditional bladder augmentation surgeries that use segments of the intestine. This approach could reduce complications associated with using intestinal tissue, such as mucus production and electrolyte imbalances.2491011

Research Team

RJ

Robert J Evans, MD

Principal Investigator

Atrium Health Wake Forest Baptist

Eligibility Criteria

This trial is for individuals with a neurogenic bladder who have not responded to standard medical treatments and are able to perform self-catheterization. They must have a small bladder capacity (<150cc) or poor bladder compliance, and be willing to consent in English. Excluded are those with recent surgeries, infections like HIV/HBV/HCV/TB, allergies to certain materials, drug abuse history, pregnant or breastfeeding women, and those on certain medications.

Inclusion Criteria

My bladder is small and/or scarred but not due to nerve issues.
Willing and able to give signed informed consent in English
I have had new kidney or bladder issues in the last year.
See 5 more

Exclusion Criteria

Prior participation in the study
Current incarceration for any reason
I am not pregnant, planning to become pregnant, or breastfeeding.
See 26 more

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Cell Expansion and Neo-Bladder Construction

Participants undergo a bladder biopsy, and cells are expanded ex vivo to create the neo-bladder construct

5-7 weeks

Surgical Implantation

The neo-bladder construct is surgically implanted onto the native bladder during augmentation cystoplasty

1 week

Follow-up

Participants are monitored for safety and effectiveness after treatment

36 months

Treatment Details

Interventions

  • Neo-Bladder Construct
Trial OverviewThe study tests an autologous 'neo-bladder' construct surgically attached to the patient's bladder as a new treatment method for improving urine collection in patients with fibrotic or contracted bladders. The safety and effectiveness of this neo-bladder will be evaluated over time.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Autologous "Neo-Bladder" ConstructExperimental Treatment1 Intervention
All subjects enrolled will have non-neurogenic, fibrotic contracted bladder that is refractory to medical treatment and require augmentation cystoplasty for preventing long-term sequelae (i.e., kidney failure) that result from persistently high intravesical pressure.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Wake Forest University Health Sciences

Lead Sponsor

Trials
1,432
Recruited
2,506,000+

References

Long-term follow-up of sigmoid bladder augmentation for low-compliance neurogenic bladder. [2014]
Long-term effectiveness and complication rates of bladder augmentation in patients with neurogenic bladder dysfunction: A systematic review. [2021]
Long-term functional outcomes of augmentation cystoplasty in adult spina bifida patients: A single-center experience in a multidisciplinary team. [2020]
Management of sphincter insufficiency in patients with neurogenic bladder and bladder augmentation. [2023]
Small bowel augmentation in children with neurogenic bladder: an initial report of urodynamic findings. [2019]
Long-term effectiveness and safety of bladder augmentation in spina bifida patients. [2021]
Quality of life after suprapubic catheter placement in patients with neurogenic bladder conditions. [2018]
Improvement of bladder function after bladder augmentation surgery: a report of 26 years of clinical experience. [2022]
Augmentation cystoplasty in neurogenic bladder. [2018]
Outcome of augmentation sigmoidocystoplasty in children with neurogenic bladder. [2017]
11.United Statespubmed.ncbi.nlm.nih.gov
Augmentation cystoplasty in the treatment of neurogenic bladder dysfunction. [2019]