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State-dependent bioelectronic interface to control bladder function.

James A Hokanson1, Christopher L Langdale1, Arun Sridhar2

  • 1Department of Biomedical Engineering, Duke University, Durham, NC, USA.

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Summary

State-dependent electrical stimulation improves bladder capacity and voiding efficiency. This novel approach offers a potential treatment for complex bladder disorders like incontinence and retention.

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Area of Science:

  • Neuroscience
  • Urology
  • Bioelectronic Medicine

Background:

  • Electrical stimulation therapies for bladder control often use continuous inhibitory stimulation.
  • Continuous stimulation can increase bladder capacity but impair voiding efficiency.

Purpose of the Study:

  • To investigate if state-dependent electrical stimulation can improve both bladder capacity and voiding efficiency.
  • To compare state-dependent stimulation with continuous stimulation in preclinical models.

Main Methods:

  • Utilized state-dependent electrical stimulation with varying parameters during bladder filling and emptying phases.
  • Tested the approach in male and female rats and cats.
  • Measured changes in bladder capacity (BC) and voiding efficiency (VE).

Main Results:

  • Continuous 10 Hz pudendal nerve stimulation increased BC (120-180%) but decreased VE (12-71%).
  • State-dependent stimulation significantly increased VE (280-759% relative to continuous stimulation) in both species.
  • Motor bursting stimulation in cats enhanced VE beyond control levels.

Conclusions:

  • State-dependent electrical stimulation offers a dual benefit for bladder function, improving both capacity and emptying.
  • This bioelectronic approach shows promise for treating complex voiding disorders, including co-existing incontinence and retention.