Conditional Electrical Stimulation in Animal and Human Models for Neurogenic Bladder: Working Toward a Neuroprosthesis

Research output: Contribution to journalReview articlepeer-review

9 Scopus citations

Abstract

Sacral neuromodulation has had a tremendous impact on the treatment of urinary incontinence and lower urinary tract symptoms for patients with neurologic conditions. This stimulation does not use real-time data from the body or input from the patient. Incorporating this is the goal of those pursuing a neuroprosthesis to enhance bladder function for these patients. Investigators have demonstrated the effectiveness of conditional (also called closed-loop) feedback in animal models as well as limited human studies. Dorsal genital nerve, pudendal nerve, S3 afferent nerve roots, and S1 and S2 ganglia have all been used as targets for stimulation. Most of these have also been used as sources of afferent nerve information using sophisticated nerve electrode arrays and filtering algorithms to detect significant bladder events and even to estimate the fullness of the bladder. There are problems with afferent nerve sensing, however. Some of these include sensor migration and low signal-to-noise ratios. Implantable pressure sensors have also been investigated that have their own unique challenges, such as erosion and sensor drift. As technology improves, an intelligent neuroprosthesis with the ability to sense significant bladder events and stimulate as needed will evolve.

Original languageEnglish (US)
Pages (from-to)379-385
Number of pages7
JournalCurrent Bladder Dysfunction Reports
Volume11
Issue number4
DOIs
StatePublished - Dec 1 2016

Keywords

  • Neurogenic bladder
  • Neuroprosthesis
  • Sacral neuromodulationk
  • Urinary incontinence

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology

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