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                        JeffNEWS, August 16, 1994
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New Procedure Holds Promise for Restoring Function of Nonworking Bladders
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Jefferson urologists may have found a way to eliminate the need for 
indwelling catheters or self-catheterization in patients whose bladders 
don't contract normally because they have spinal-cord injuries, diabetes, 
pelvic cancers, herniated discs or birth defects.

This new procedure could be the first practical solution to the problem, 
according to Michael B. Chancellor, MD, assistant professor of urology.  

What Dr. Chancellor and his colleagues have done is apply to the 
nonfunctioning bladder a technique that helps failing hearts to beat.

The technique used with the bladder consists of wrapping a portion of 
the rectus abdominis muscle in the stomach/abdominal area, with its nerves 
and blood supply intact, completely around the bladder and implanting a 
programmable generator into the muscle.

Every four to six hours, the time it usually takes for the bladder to 
fill, the patient runs a magnet externally over the area where the 
generator has been implanted. This makes the generator contract the muscle 
wrapped around the bladder, so that the urine which has been collecting 
inside the bladder is expelled.

Dr. Chancellor, along with David A. Rivas, MD, instructor in urology, 
and Steven K. Salzman, PhD, associate professor of pediatrics, successfully 
treated one patient with this technique 17 months ago.

"Eliminating the need for a catheter practically eliminates the risk of 
infection, to say nothing of the discomfort and inconvenience," Dr. 
Chancellor said.

The team hopes soon to receive Food and Drug Administration clearance to 
perform this investigational procedure on a small group of patients.

In 1993, the new idea was the subject of an essay that won the Jack 
Lapides International Neurourology Essay Contest.


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Information provided by:  Editor, JeffNEWS
                          (215) 955-6204
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