Research Mentor Name

Dr. Nivedita Dhar

Research Mentor Email Address

ec0362@wayne.edu

Institution / Department

Detroit Medical Center

Document Type

Research Abstract

Research Type

clinicalresearch

Level of Research

yes

Abstract

Introduction:

SARS-coV-2 is linked to genitourinary symptoms of overactive bladder (OAB), marked by increased frequency, urgency, and nocturia, and has been recently labeled COVID-associated cystitis (CAC). The predominant pathophysiology is proposed to be overexpression of pro-inflammatory cytokines causing bladder inflammation, fibrosis, and bothersome urinary symptoms. Research supports that amniotic membrane (AM) can be used to induce apoptosis of pro-inflammatory cells, inhibit differentiation of pro-fibrotic cells, and expedite wound healing. We investigated the therapeutic response and safety of AM in 5 CAC patients with resistant OAB symptoms.

Methods:

All study patients were admitted for treatment of COVID-19 in spring 2019 and on discharge complained of de novo OAB symptoms. Five CAC patients with a mean age of 73 ± 1.0 years and a median disease duration of 2.4 years received intra detrusor injections of reconstituted 100mg micronized AM under general anesthesia and were followed for 20 weeks. OAB Assessment Tool, volume of first involuntary detrusor contraction and maximum cystometric capacity were measured as the objective parameters to assess treatment response.

Results

All patients demonstrated improved bladder function on urodynamic studies and OAB Assessment scores at 4 weeks post-treatment and were sustained until 12 weeks. At 20 weeks recurrence of symptoms were observed in all patients (Table 1, Figure 1). No safety concerns arose during the study.

Conclusion

These results indicate the promise of ABT as a viable treatment for CAC patients with refractory OAB symptoms. More comprehensive studies in managing CAC with ABT is needed to validate its therapeutic potential.

Disciplines

Medicine and Health Sciences

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