Project Summary:
Lower urinary tract symptoms or LUTS—including urinary urgency, frequency, urinary incontinence, nocturia, interstitial cystitis, etc.—are estimated to afflict 50% of adults and have substantial, wide-ranging impacts. Limited data exist on the prevalence of LUTS in Wisconsin residents. However, a recent study by the University of Wisconsin-Madison surveyed 399 Wisconsin women and found 62% had incontinence (42% had urinary incontinence only, 3% had bowel incontinence only, 17% had both). These numbers are in agreement with national averages and highlight the need for addressing LUTS in Wisconsin.
Electrical stimulation of the tibial nerve is an approach used to treat urinary incontinence. Its use, however, is currently limited due to its method of application, wherein people need to visit the doctor frequently (initially once per week, eventually roughly once per month) to receive treatment. Several companies have developed implantable tibial nerve stimulators, removing the need for frequent visits to the doctor, and thus it is expected that going forward the use of tibial nerve stimulation will increase dramatically.
Although there is great potential for increased use, there remains room for improvement in therapeutic efficacy. The way in which this therapy is delivered, specifically the stimulation parameters used, has remained largely unchanged since its introduction in the late 1990s. Additionally, it is unclear how this therapy works or why some people respond well to this therapy and others do not. This latter problem is important as currently, people progress from therapy to therapy with minimal individualized treatment, leading to a waste of resources and rising patient frustration.
In this project, the research team will develop an animal model of tibial nerve stimulation to treat bladder dysfunction. This will enable subsequent projects (e.g., NIH R01 applications) where the team will work to develop a better understanding of how to improve this therapy, as well as a better understanding of its limitations (and mechanisms of action), using this new animal model.
Ultimately, the researchers expect this line of research will lead to improvements in the treatment of urinary incontinence as well as improvements in the ability to identify people who will respond well to this particular therapy.