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11–14 APRIL, 2018, HELSINKI, FINLAND
14:27–14:30
S1-13 (PP)
★
ESWT PROTECTS FROM BLADDER DYSFUNCTION
AFTER TRAUMATIC SPINAL CORD INJURY VIA A TOLL-LIKE
RECEPTOR 3 DEPENDENT MECHANISM
Felix NÄGELE
1
, Angela AN
1
, Michael GRABER
1
, Christian KREMSER
2
, Daniela
LOBENWEIN
3
, Bernhard HAID
4
, Leo PÖLZL
5
, Jakob HIRSCH
1
, Elke KIRCHMAIR
1
,
Michael GRIMM
1
, Johannes HOLFELD
1
and Can TEPEKÖYLÜ
1
1) Innsbruck Medical University, University Hospital for Cardiac Surgery, Innsbruck, AUSTRIA - 2) Innsbruck Medical
University, Deptartment of Radiology, Innsbruck, AUSTRIA - 3) Innbruck Medical University, Division of Clinical and
Functional Anatomy, Department of Anatomy, Histology and Embryology, Innsbruck, AUSTRIA - 4) Hospital of the Sisters
of Charity, Pediatric Urology, Linz, AUSTRIA - 5) Innbruck Medical University, University Hospital for Cardiac Surgery,
Innsbruck, AUSTRIA
PURPOSE
Traumatic spinal cord injury (TSCI) causes neurogenic bladder dysfunction, which predisposes to
urinary tract infections (UTI) and, ultimately, upper tract damage leading to renal failure. In the
present mouse model, UTIs are the main cause of death after TSCI. Neuroprotective effects of
low-energy shock wave treatment (SWT) via a toll-like receptor 3 (TLR3) dependent mechanism
were described previously. We hypothesised that SWT after TSCI prevents bladder dysfunction by
minimising neurodegeneration.
MATERIAL AND METHODS
Clip-contusion TSCI was performed in either C57BL/6 wild type (WT) or TLR3 knockout (TLR3-
/-) mice (n=20 per group). Randomly assigned treatment groups (n=10 WT and n=10 TLR3-/-)
received SWT (500 shocks / 500 J/mm2) 14 days post-operatively. All animals underwent high
resolution 3D MRI imaging after 72 days of follow-up. Mortality was recorded, spinal cord scar size
and residual urine volumes were measured using OsiriX software.
RESULTS
MRI measurements showed statistically significant reduced residual urine volumes (0.25+/-
0.05 mm3 vs. 0.82+/-0.08 mm3, p<0.05) and less spinal cord scarring (0.85+/-0.05 mm2 vs. 2.6+/-
0.3 mm2) in treated WT animals. Overall survival was higher in treated WT animals compared to
the untreated control group (9 vs. 7, n.s.). Shock wave effects were abolished in TLR3 knockout
groups (residual urine volume: 0.9+/-0.2 vs. 0.65+/-0.35, n.s.; spinal cord scar size: 1.7+/-0.2 mm2
vs. 1.4+/-0.03 mm2, n.s.).
CONCLUSIONS
SWT prevents damage to bladder function after TSCI in a mouse model. This may indicate a pos-
sible novel strategy of treating neurogenic bladder dysfunction after acute spinal injury.