7. BIONIC BLADDER

BIONIC BLADDER ‘Evolving the Bionic Bladder: towards complete electrical control of continence and
micturition’. PI: Dr Benjamin Metcalfe.

Locations: University of Bath, Oxford University, the Walton Centre, Finetech Medical Ltd, Royal Veterinary College.
Duration/Dates Cost: 28 months. Jan 2024 – Apr 2026                         Total project costs £213,146

Abstract

Bladder function is often compromised following spinal cord injury. The loss of supra-spinal input affects both storage and micturition, leading to episodic incontinence and catheterisation. Improvement of bladder management is critical to long-term health and wellbeing. Sacral anterior root stimulation (SARS) devices are implanted to restore bladder control, however a sacral dorsal rhizotomy (SDR) currently accompanies implantations to remove neurogenic detrusor overactivity and detrusor sphincter dyssynergia. The result is satisfactory, but the SDR abolishes reflex erection and ejaculation in men and sacral sensation in incomplete patients.

It is theoretically possible to avoid SDR, and the resulting loss of function, by using on-demand electrical neuromodulation. This should be possible with minor updates to the SARS device, enabling rapid translation. The required modelling, development, and clinical pilot studies of this approach are the focus of this project. The results will feed into a pilot trial offering next-generation SARS without SDR.

 Anticipated Outcome

Restoration of bladder control is a top priority to the SCI population, where incontinence and catheter associated infections may be regular and are extremely detrimental to individuals’ quality of life. Our research is exciting as it involves the translation of techniques into new devices that may provide on demand control of the bladder and bowel. The fact that neuromodulation can be used on-demand, to immediately suppress an unwanted contraction of the bladder or trigger a wanted contraction, distinguishes it from existing therapies. We are in the early stages of trialling this technique in hospital labs. Looking to the future there is evidence that this is a technique that may be used by people with many pathologies either in combination with or instead of pharmaceutical therapies.  BIONIC BLADDER will give us proof-of-concept evidence of neuro-stimulation’s potential; if successful, good baseline data will be harnessed to seek further funding for larger bodies to run a randomised controlled trial.

Flyer BIONIC BLADDER Jan 24