Closed loop electrical control of urinary continence

The Journal of Urology
Brian J WenzelWarren M Grill

Abstract

Individuals with spinal cord injury or neurological disorders may have neurogenic detrusor contractions at low volumes (bladder hyperreflexia), which cause incontinence and can lead to significant health problems. Bladder contractions can be suppressed by electrical stimulation of inhibitory pathways but continuous activation may lead to habituation of the inhibitory reflex and loss of continence. We determined whether conditional stimulation with electrical stimulation of inhibitory pathways applied only at the onset of nascent bladder contractions allows the bladder to fill to a greater volume before continence is lost compared with continuous stimulation. In 6 alpha-chloralose anesthetized cats cystometry was performed to compare the volume at which continence was lost under the conditions of no stimulation, continuous stimulation and conditional electrical stimulation of inhibitory pathways. PNT ENG was used to detect the onset of bladder contractions and it served as the input to an event triggered control system that regulated conditional stimulation to maintain continence. Conditional stimulation controlled by PNT ENG increased bladder capacity by 36% over no stimulation and by 15% over continuous stimulation (p <0.001 a...Continue Reading

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Citations

Feb 14, 2007·Annals of Biomedical Engineering·B E LewandowskiK J Gustafson
Apr 25, 2008·American Journal of Physiology. Regulatory, Integrative and Comparative Physiology·John P WoockWarren M Grill
Jan 15, 2015·The Journal of Spinal Cord Medicine·Meredith J McGeeWarren M Grill
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Nov 17, 2017·American Journal of Physiology. Renal Physiology·James A HokansonWarren M Grill
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Jan 3, 2019·International Neurourology Journal·Eunkyoung ParkKyu-Sung Lee
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Feb 9, 2021·Biosensors & Bioelectronics·Tucker StuartPhilipp Gutruf
Nov 18, 2020·Journal of Neural Engineering·Carl Henning LubbaSimon Schultz
Nov 6, 2021·Journal of Neural Engineering·Calvin D EiberJames B Fallon

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