Title : Efficacy of amniotic bladder therapy for individuals with overactive bladder: A pilot study
Abstract:
Introduction and Objectives: Inflammation may play a pathogenic role in overactive bladder (OAB) by inducing significant fibrosis of the detrusor and submucosal tissues, making them less “flexible” resulting in a decrease in bladder capacity. Therefore, treatments that aim to resolve inflammation, prevent fibrosis, and promote urothelial healing may help alleviate OAB symptoms. The anti-inflammatory and anti-fibrotic properties of amniotic membrane (AM) has generated considerable interest. In this study, we investigated the safety and efficacy of bladder injections of AM in patients who were experiencing resistant OAB symptoms.
Methods: Patients affected by OAB who failed conventional therapy received intra-detrusor injections, under general anesthesia, of reconstituted 100mg micronized AM and were followed for 36 weeks. Key urodynamic (UDS) assessments (involuntary detrusor contraction (IDC) and maximum cystometric capacity (MCC) were used to provide objective measures of the treatment effect on bladder function. The impact of treatment on quality of life was assessed using the OAB Assessment Tool. The safety of injections was analyzed.
Results: Fifteen consecutive female patients with an average age of 55 ± 7 years and a median disease duration of 8 years were studied. After amniotic bladder therapy, positive treatment effects were reflected by improvements in bladder function as assessed by UDS up to 12 weeks, with decline at 24 weeks and 36 weeks. (Figure 1) The average OAB score exhibited a progressive improvement from baseline to 12 weeks and then worsened until 36 weeks. (Figure 2) No adverse events were observed.
Conclusion: ABT treatment's efficacy appears to decline after 12 weeks. This preliminary feasibility study warrants further comprehensive investigation to assess the potential clinical efficacy of ABT.
Audience Take Away:
- Clinicians can learn more about the clinical potential of amniotic membrane therapy’s anti-inflammatory and anti-fibrotic properties.
- Clinicians will have another option they can offer women in their clinic with OAB refractory to conventional therapy.
- Clinicians will be able to put amniotic bladder therapy to immediate clinical use in female patients who have failed conventional therapy with a preliminary study that will help guide management and expectations of treatment.
- This research can serve as a starting point for other faculty to do novel research studying the effects of amniotic bladder therapy for various urogynecologic issues.
