We have developed an electronic system for detecting when the urinary bladder of a person with a spinal cord injury begins to contract involuntarily and used these signals to activate the stimulation of sensory sacral nerves, which then immediately suppresses the contraction. This so-called conditional neuromodulation, involving electronic processing circuitry to provide the feed-back pathway, is able to significantly increase bladder capacity and reduce the incidence of urinary incontinence.
We have demonstrated that conditional neuromodulation can be used both as a relatively non-invasive technique and, more appropriately, as a hybrid technique by applying the stimulation through an implanted posterior (sensory) nerve root stimulator.
It is the ultimate intention in future development to combine sensing and conditional stimulation through the posterior nerve roots with sacral anterior root stimulation for bladder emptying so as to provide patients with complete control over their lower urinary tract. Such control would be the ideal long-term management for people with spinal cord injuries and hopefully have a significantly good impact on their quality of life.