Improving bladder control to prevent incontinence

Why is a new treatment needed for urinary incontinence?

The loss of bladder control, or urinary incontinence, affects over 1 in 4 Australian adults [1].

There are limited treatment options available for urinary incontinence, most of which have limited effectiveness.

Although not life threatening, urinary incontinence is an embarrassing problem, and has significant mental health and social impacts.

It also poses a huge burden on the Australian health care system, costing an estimated $450 million in direct health costs [2].

Restoring bladder control with sensing and stimulation

Electricity can be used to alter the activity of peripheral nerves to control the function of an organ. Our technology will deliver electricity to bladder nerves to allow control over when the bladder is emptied.

A critical aspect of our treatment strategy is being able to deliver electricity at precise moments, when the bladder is at a certain degree of fullness.

To do this, we are developing new ‘sensing’ technology that detects bladder pressure and therefore, how full the bladder is.

Just as bladder nerves can be used to control bladder function, the same nerves can also be used to inform on bladder pressure.

Combined together our ‘stimulating’ and ‘sensing’ technology will allow adaptive control over bladder function. If successful, patients will never have to worry about loss of bladder control again.

Next steps for Bionics Institute researchers

Our novel sensing technology is currently being optimised and still requires validation under a range of relevant conditions, which is currently underway.

We have demonstrated an ability to start urination, with experiments exploring the best way to electrically stimulate the nerve to delay urination currently being planned.

The research team

BI researchers:

Professor James Fallon (PI), Dr Sophie Payne, Jerico Matarazzo, Chris Bowman

External Researchers:

Professor Janet Keast (PI, University of Melbourne), Dr Peregrine Osborne (University of Melbourne),

More information for researchers

The use of electric medicine devices to stimulate the autonomic nervous system for the treatment of medical conditions, such as urinary disorders, has gained significant momentum in the medical research community.

However, most devices used to deliver bioelectric therapy are open-loop and provide a fixed level of stimulation that does not respond to individual needs.

The next generation of bioelectric neuromodulation devices aim to provide closed loop (adaptive) control, in which the level of stimulation adjusts to a patient’s rapidly changing needs.

Developing a real-time biomarker using the nervous system allows for quick, accurate feedback regarding physiological state of the end organ is the first step in developing closed-loop technology.

In this project, we aim to demonstrate closed loop (adaptive) control over bladder function for the treatment of urinary incontinence.

Publications

Calvin D Eiber et al 2021 J. Neural Eng. https://doi.org/10.1088/1741-2552/ac36e2

Payne et al., 2020. Front in Neuro. http://doi.org/10.3389/fnins.2020.619275

Payne et al., 2018. Nat Rev Gastorl & Heptol https://doi.org/10.1038/s41575-018-0078-6