Lightly talked about but very impactful — bladder disorders.

November is National Bladder Health Awareness month. There are many factors impacting bladder health. For those living with bladder issues, it can be life-impacting. In the neurotechnology space, there are several options for people living with urinary incontinence, or overactive bladder.

There are two main types of urinary incontinence: Urge incontinence is characterized by the frequent urge to urinate, often accompanied by leakage and discomfort. Stress incontinence results from ineffective muscle control, tissue damage, or muscle weakness within the pelvic floor. Individuals with either form of incontinence often must wear protective devices under their clothing.

Over 15 million people in the U.S. suffer from urge incontinence and more than twice that number worldwide. There are currently several types of pharmaceutical products on the market used to treat urinary urge incontinence, such as Ditropan and Detrol, anticholinergic agents that attempt to block receptors in the bladder muscle. However, these drugs have side effects such as dry mouth, dry skin, visual blurring, nausea, and constipation. The most severe cases, between 500,000 and 1.5 million individuals worldwide, are candidates for electrical stimulation treatment.

There are a few categories of neurotechnology devices for the treatment of bladder disorders. They are:

• Sacral Nerve Stimulator: Implanted device to control the bladder by sending electrical impulses to the nerve that controls the bladder, sacral nerve, sphincter and the muscles around it. Commercially available devices include the Interstim II device from Medtronic and the r-SNM device from Axonics.
• Tibial Nerve Stimulator: Uses percutaneous electrodes or minimally-invasive implanted eletrodes to control the bladder by stimulating the tibial nerve in the lower leg. The Urgent PC device from Laborie has been available for some time but others have emerged onto the market including NURO device from Medtronic, Protect PNS from UroMedical and the Renova therapy from BlueWind (only available in Europe).
• Pelvic Floor Stimulator: Provides stimulation to the pelvic floor muscles to improve the opening and closing of the urethral. These are conditioning devices like the Liberty from Utah Medical and NeoControl from Kitalpha. Atlantic Therapeutics has entered the market with a wearable device called the Innovo.
• Direct Muscle Stimulation: Uses an implanted electrode to stimulate the bladder and muscles around it. The Fintech Brindley Bladder Control stimulator involves a surgical procedure but has a long standing device reliability for those choosing to use it.
• Biofeedback: These are non-invasive devices used for training the body-brain connection to help with re-training the bladder systems typically following an event causing incontinence. Such device are the Inwave device from Zynex Medical or the NeuroTrac device from Verity Medical. Thought Technologies is developing a new tool for this application.

There are several modalities under investigation in human clinical trials. One such device is a non-invasive, wearable device sponsored by EBT Medical that stimulations the saphenous nerve in the lower leg. Other notable non-invasive therapies under investigation include devices from FemPulse, StimRoutner (Biovations) and Avation Medical. Coloplast recently purchased the Nine Continents Medical iTNS device for OAB. In addition, Medipace and Neuspera are companies developing new technologies to stimulate the sacral nerve for bladder control is a less invasive manner.

An implanted device, currently under investigation, uses electrodes to stimulate the pudendal nerve to provide bladder function. Sacral Magnetic Stimulation is also being investigated for refractory stress urinary incontinence. Other neurotechnology systems under development include vagus nerve and genital nerve stimulation.

The content for this article was provided by Neurotech Network. Neurotech Network offers free resources and a directory of devices specifically for Bladder & Bowel Disorders. Check out our page here.