Review Recommendations for evaluation of bladder and bowel function in pre-clinical spinal cord injury research

The Journal of Spinal Cord Medicine, 2020 · DOI: 10.1080/10790268.2019.1661697 · Published: January 1, 2020

Spinal Cord Injury Urology Research Methodology & Design

Simple Explanation

This paper identifies and categorizes outcome measures for pre-clinical assessment of bladder and bowel function with broad applicability to animal models of SCI. Drawing upon the collective research experience of autonomic physiologists and informed in consultation with clinical experts, a critical assessment of currently available bladder and bowel outcome measures was made. Several fundamental assessments share reasonable levels of technical and material investment, including some that could assess bladder and bowel function non-invasively and simultaneously.

Study Duration

Not specified

Participants

Animal models of SCI

Evidence Level

Review

Key Findings

1
Three fundamental measures each for bladder and bowel assessments were identified, centering upon tissue morphology, voiding efficiency/volume, and smooth muscle-mediated pressure studies.
2
Additional assessment measures were categorized as recommended, supplemental or exploratory based upon the balance between technical requirements and potential mechanistic insights to be gained by the study.
3
Assessments include histological, biochemical, in vivo functional, ex vivo physiological and electrophysiological tests.

Research Summary

The goal of this article is to provide guidance for selection of bladder and bowel measures applicable as either primary or ancillary outcomes. Several fundamental assessments share reasonable levels of technical and material investment, including some that could assess bladder and bowel function non-invasively and simultaneously. Adopting these recommendations will help refine those animal models of neurogenic bladder and bowel that reliably predict success in clinical testing.

Practical Implications

Standardized outcome measures

The paper provides standardized outcome measures that can be adopted by laboratories studying animal models of SCI.

Enhanced research

Adopting the recommendations can enhance research in bladder and bowel function after SCI.

Translational consensus

The recommendations address the shortfall in preclinical studies utilizing assessments of bladder and bowel function, which limits the development of a translational consensus in the field.

Study Limitations

1
The number of studies using methods that assess colonic function in preclinical SCI models is considerably smaller.
2
Usage by multiple research groups was given heavy consideration for inclusion (although for practical reasons, not all groups could be cited).
3
Selection of outcome measures is study-specific and dependent upon the level and severity of SCI.

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