A University of Houston researcher is working to reverse pelvic floor dysfunction which can result in urinary incontinence, a condition affecting 30-60% of the female population and 5-15% of males. Stress urinary incontinence (SUI), the most common type of urinary incontinence in women, relates to the unintentional loss of urine which happens during movement or activities like sneezing, coughing or exercising. The condition is associated with pregnancy and aging and affects the pelvic floor, a group of muscles stretching from the pubic bone to the tail bone that contributes to continence.
"Reduced amplitude or disorganized pattern of activity in individual muscles critically impact their ability to maintain the urethra closed, resulting in urine leakage," said Mario Ignacio Romero-Ortega, Cullen Endowed Professor of Biomedical Engineering. "We hypothesize that selective and coordinated stimulation of individual pelvic floor muscle (PFM) nerves will re-establish their normal strength and activity patterns, effectively reversing the symptoms of UI." Romero-Ortega has received $1.6 million from the National Institute of Diabetes and Digestive and Kidney Diseases to prove his theory.
The innovative work uses state-of-the-art miniaturized wireless electrodes to bring together small PFM efferent nerves and directly modulate their individual activity.
"We postulate that wireless electrical stimulation of specific PFM nerves can be used to reestablish their normal physiological activity patterns to alleviate voiding dysfunction in UI," said Romero-Ortega.
Preliminary results are positive.
Selective pelvic floor neuromodulation (SPFN) of the pelvic floor nerve controlling the pubococcygeus muscle reduced bladder storage capacity and voiding efficiency. In sharp contrast, stimulation of the nerve controlling the bulbospongiosus muscle produced the opposite result, significantly increasing the maximum bladder pressure and increasing voiding efficiency.
"These results offer a compelling demonstration for the control of bladder function by electrical stimulation of individual PFMs motor nerves, opening the possibility for SPFN as new therapy for pelvic floor disorders," said Romero-Ortega.