Proof of concept project

Pelvic Nerve Stimulation to Control Urinary Incontinence

Jon Crook and Thelma Lovick1
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  • Date Published

    March 2016

  • Principal Investigator

    Dr Thelma Lovick, University of Bristol

  • Co-Investigators

Summary

One current treatment for urinary incontinence is stimulation of the sacral nerve in the lower back however success rates are only around 50%. As an alternative to this method Pelvic Nerve Stimulation to Control Urinary Incontinence at Bristol University will explore the principle of an implantable device operated by the user which would temporarily block messages sent from the pelvic nerve at the onset of the urge sensation to allow extra time to reach a toilet.  Funding from IMPRESS will allow lab tests to further explore the feasibility of this approach.

Urge Urinary urge incontinence (UUI) is defined as “a sudden compelling desire to pass urine, which is difficult to defer”. 

UUI is rated as the most bothersome of lower urinary tract symptoms (Argawal et al, 2014). Prevalence rates of 13.3% for men and 30.0% for women have been reported in the UK, USA and Sweden (Milsom et al, 2014).  The condition causes considerable distress to sufferers.

Currently UUI is not well managed. The underlying pathology is not understood but may lie in the bladder (overactive bladder) or alternatively, the micturition control circuitry in the brain and/or spinal cord may be at fault.

Urinary voiding is dependent on the integrated contraction of the detrusor muscle, and relaxation of the external urethral sphincter to permit urine to flow.

These two events are controlled respectively the pelvic and pudendal nerves under the control of the central nervous system. Under normal circumstances, the central circuitry permits voiding to occur only when it is safe and socially acceptable for the individual to do so.  In UUI this control appears to be lost.

Image above taken from full report showing rig developed during research

Aims

This project aims to develop an activity in incontinence tribology bringing leaders in the area of engineering tribology, cellular biology and incontinence technologies together in an attempt to bridge the apparent gap. This initial PoC project will facilitate further meetings with leading academics in the area as well as some initial laboratory investigations to form the PoC for future grant application.

aims

We sought to produce an effect that was rapid in onset and offset, could be sustained for several minutes, was repeatable and produced minimal ‘off target’ effects on other organ systems.  If the initial proof of concept experiments in anaesthetised rats proved successful, the next stage of the work would be to translate the findings to chronically instrumented conscious animals.

Incontinence Management & PRevention through Engineering and ScienceS