Related Experiment Video
Updated: Jul 31, 2025
03:26
Detrusor Underactivity Model in Rats by Conus Medullaris Transection
Published on: August 28, 2020
2.1K
Automated closed-loop stimulation to inhibit neurogenic bladder overactivity.
Steve Majerus1,2,3, Carvell Nguyen4, Steven Brose5,6
1Advanced Platform Technology Center, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA.
Summary
A new algorithm automatically detects bladder contractions in individuals with spinal cord injury (SCI) and triggers genital nerve stimulation (GNS) to inhibit them, showing feasibility for closed-loop bladder control.
Area of Science:
- Neurology
- Urology
- Biomedical Engineering
Background:
- Spinal cord injury (SCI) frequently leads to neurogenic detrusor overactivity (NDO), causing bladder dysfunction, urgency, incontinence, and diminished quality of life.
- Genital nerve stimulation (GNS) is a known method to suppress involuntary bladder contractions in SCI patients.
- Current GNS approaches lack automation, necessitating the development of closed-loop systems for improved efficacy and patient experience.
Purpose of the Study:
- To evaluate the feasibility of an automated closed-loop system for GNS, utilizing a custom algorithm to detect and inhibit bladder contractions in real-time.
- To assess the system's ability to identify bladder contractions using only bladder pressure data, without requiring abdominal pressure measurements.
Main Methods:
- A pilot study involving four participants with SCI and NDO was conducted in a urodynamics laboratory.
- A custom algorithm monitored bladder pressure to detect contractions and automatically triggered GNS.
- Participants underwent standard cystometrograms with and without the closed-loop GNS system.
Main Results:
- The custom algorithm successfully detected bladder contractions in real-time, inhibiting 56 contractions across all subjects.
- The system demonstrated a detection and stimulation trigger time of approximately 4.0 ± 2.6 seconds.
- Automated closed-loop GNS was well-tolerated, with participants reporting alignment between algorithm actions and their perceived bladder activity.
Conclusions:
- The developed custom algorithm is feasible for automated closed-loop neuromodulation, effectively identifying bladder contractions and triggering GNS for acute inhibition.
- This pilot study demonstrates the potential of automated closed-loop GNS as a viable approach for managing NDO in SCI.
- Further research and refinement are necessary to optimize this system for potential home-use applications.
Related Concept Videos
01:26The Micturition Reflex
787
Urination, or micturition involves the coordination of the bladder's detrusor muscle and two sphincters to ensure controlled bladder emptying.
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
The process begins with bladder filling, where the bladder wall stretches as urine accumulates. This stretching activates the urine storage reflex, mediated by the sacral spinal segments and the pontine storage center. Efferent sympathetic impulses stimulate the detrusor muscle to relax and the internal urethral sphincter to contract, facilitating...
787
01:23Urinary Bladder
1.1K
The urinary bladder is a hollow, muscular sac that temporarily stores urine before it is expelled from the body. It can hold approximately 600 mL of urine prior to micturition. The bladder is retroperitoneal and located behind the pubic symphysis in the pelvic floor.
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
In males, the bladder is situated in front of the rectum, while in females, it is positioned anterior to the vagina and uterus. The bladder floor contains an inverted triangular area called the trigone, defined by the two ureteric...
1.1K